Appendix 2 – Measure Definitions Choosing Wisely: Prevalence and Correlates of Low-Value Health Care Services in the United States Carrie H Colla, Nancy E Morden, Thomas D Sequist, William L Schpero, Meredith B Rosenthal Table of Contents Methods for Measuring Low-Value Diagnostic Services Back Pain Imaging (pp. 2) Benign Prostatic Hyperplasia Imaging (pp. 5) Cardiac Screening (pp. 7) Cervical Cancer Screening (pp. 73) Dual-Energy X-ray Absorptiometry (DXA) Testing (pp. 75) Preoperative Cardiac Testing (cataract surgery) (pp. 77) Preoperative Cardiac Testing (non-cardiac surgery) (pp. 171) Vitamin D Screening (pp. 175) Methods for Measuring Low-Value Treatments Antipsychotics in Dementia Patients (pp. 178) Feeding Tubes in Dementia Patients (pp. 181) Opioids for Migraines (pp. 184) Abbreviations BETOS: Berenson-Eggers Type of Service CPT: Current Procedural Terminology CCS: Clinical Classifications Software HCC: Hierarchical Condition Categories ICD-9: International Statistical Classification of Diseases, Ninth Edition 1 Don't do imaging for low back pain when no red flags are present Choosing Wisely Guidelines American Academy of Family Physicians American College of Physicians North American Spine Society Don’t do imaging for low back pain within the first six weeks, unless red flags are present. Red flags include, but are not limited to, severe or progressive neurological deficits or when serious underlying conditions such as osteomyelitis are suspected. Imaging of the lower spine before six weeks does not improve outcomes, but does increase costs. Low back pain is the fifth most common reason for all physician visits. Don’t obtain imaging studies in patients with non-specific low back pain. In patients with back pain that cannot be attributed to a specific disease or spinal abnormality following a history and physical examination (e.g., non-specific low back pain), imaging with plain radiography, computed tomography (CT) scan, or magnetic resonance imaging (MRI) does not improve patient outcomes. Don’t recommend advanced imaging (e.g., MRI) of the spine within the first six weeks in patients with non-specific acute low back pain in the absence of red flags. In the absence of red flags, advanced imaging within the first six weeks has not been found to improve outcomes, but does increase costs. Red flags include, but are not limited to: trauma history, unintentional weight loss, immunosuppression, history of cancer, intravenous drug use, steroid use, osteoporosis, age > 50, focal neurologic deficit and progression of symptoms. Methods We calculated the percent of Medicare beneficiaries over age 65 with any low back pain who received imaging within the first six weeks, with no red flags present, in each calendar year 2007-11. We then created a weighted average of imaging prevalence for the interval 2007-11. We required full fee-for-service Medicare Parts A and B coverage in the 12 months before the back pain diagnosis, as well as in the six weeks after. Red flags included a previous low back pain diagnosis, a cancer (excluding non-melanoma skin cancer) diagnosis at any point during the study period, or a diagnosis with an “E” code (external causes of injury), trauma, neurological impairment, IV drug use, HIV, unspecified immune deficiencies, or intraspinal abscess within the 12 months before the imaging event. For beneficiaries to be classified as having a red flag, we required at least two physician claims and/or at least one acute hospital claim (we only required one claim for the “E” code and trauma diagnoses). We also did not count imaging events that included an “E” code or trauma diagnosis in any of the first four fields on a claim. Procedure and diagnosis codes used for this measure were adapted, in part, from the National Quality Forum-endorsed National Voluntary Consensus Standards for Physician-Focused Ambulatory Care and the Centers for Medicare and Medicaid Services Hospital Outpatient Quality Reporting Specifications Manual. 2 References NQF-Endorsed National Voluntary Consensus Standards for Physician-Focused Ambulatory Care. National Committee for Quality Assurance. 2008. Hospital Outpatient Quality Reporting Specifications Manual. Centers for Medicare & Medicaid Services. 2008. ICD-9 Codes for Identifying Low Back Pain Label Lumbosacral spondylosis without myelopathy Spondylosis of unspecified site without mention of myelopathy Displacement of lumbar intervertebral disc without myelopathy Schmorl's nodes lumbar region Degeneration of lumbar or lumbosacral intervertebral disc Degeneration of intervertebral disc, site unspecified Other unspecified disc disorder of lumbar region Lumbago Sciatica Unspecified backache Disorders of sacrum Unspecified disorder of coccyx Hypermobility of coccyx Other disorder of the coccyx Other acquired deformity of back or spine Non-allopathic lesion of lumbar region, not elsewhere classified Non-allopathic lesion of sacral regions, not elsewhere classified Sprain and strain of lumbosacral (joint) (ligament) Sprain and strain of sacroiliac (ligament) Sprain and strain of sacrospinatus (ligament) Sprain and strain of sacrotuberous (ligament) Other specified sites of sacroiliac region sprain and strain Unspecified site of sacroiliac region sprain and strain Lumbar sprain and strain Code 721.3 721.90 722.10 722.32 722.52 722.6 722.93 724.2 724.3 724.5 724.6 724.70 724.71 724.79 738.5 739.3 739.4 846.0 846.1 846.2 846.3 846.8 846.9 847.2 ICD-9 and CCS Codes for Identifying Red Flags Label External causes of injury Trauma Cancer IV drug abuse Neurologic Impairment Human Immunodeficiency Virus (HIV) Code Any ICD-9 “E” code ICD-9 800, 839, 850-854, 860-869, 905-909, 926.11, 926.12, 929, 952, 958-959 CCS 11-22, 24-44 ICD-9 304.0, 304.1X, 304.2X, 304.4X, 305.4X, 305.5X, 305.6X, 305.7X ICD-9 344.60, 729.2 ICD-9 042-044 3 Unspecified immune deficiencies Intraspinal abscess ICD-9 279.3 ICD-9 324.9, 324.1 CPT Codes for Identifying Imaging Events Label X-Ray exam spine AP&LAT X-Ray exam of spine 1 view X-Ray exam L-S spine 2/3 VWS X-Ray exam lL2 spine 4/> VWS X-Ray exam L-S spine bending X-Ray bend only L-S spine X-Ray exam SI joints X-Ray exam SI joints 3/> VWS X-Ray exam sacrum tailbone MRI neck spine w/o dye MRI neck spine w/dye MRI chest spine w/o dye MRI chest spine w/dye MRI lumbar spine without contrast MRI lumbar spine with contrast MRI neck spine w/o & w/dye MRI lumbar spine with and without contrast CT lumbar spine w/o dye CT lumbar spine w/dye CT lumbar spine w/o & w/dye Code 72010 72020 72100 72110 72114 72120 72200 72202 72220 72141 72142 72146 72147 72148 72149 72156 72158 72131 72132 72133 4 Don’t order upper-tract imaging for patients with benign prostatic hyperplasia (BPH) Choosing Wisely Guidelines American Urological Association Don’t order creatinine or upper-tract imaging for patients with benign prostatic hyperplasia (BPH). When an initial evaluation shows only the presence of lower urinary tract symptoms (LUTS), if the symptoms are not significantly bothersome to the patient or if the patient doesn’t desire treatment, no further evaluation is recommended. Such patients are unlikely to experience significant health problems in the future due to their condition and can be seen again if necessary. [While the patient can often tell the provider if the symptoms are bothersome enough that he desires additional therapy, another possible option is to use a validated questionnaire to assess symptoms. For example, if the patient completes the International Prostate Symptom Scale (IPSS) and has a symptom score of 8 or greater, this is considered to be “clinically” bothersome. Methods We calculated the percent of male Medicare beneficiaries over age 65 with benign prostatic hyperplasia (BPH) who received upper urinary tract imaging within 60 days of their BPH diagnosis for each calendar year 2006-11. We then created a weighted average of imaging prevalence for the interval 2006-11. We required enrollment in fee-for-service Medicare Parts A and B within 60 days of the BPH diagnosis, which we identified using ICD-9 code 600.00. We only counted imaging events that included a diagnosis of BPH without lower urinary tract symptoms or other diagnoses that would not clinically indicate imaging in any of the first four fields on the imaging claim. We excluded beneficiaries who received “red flag” diagnoses within 60 days of the index BPH diagnosis that could appropriately indicate imaging or who had a diagnosis of cancer (except non-melanoma skin cancer) at any point during the calendar year. We also excluded beneficiaries who had more than $200 in hospice spending within 60 days of the index diagnosis. We required at least two physician claims and/or at least one acute hospital claim for all diagnoses. References Strope SA, Elliott SP, Saigal CS, Smith A, Wilt TJ, Wei JT. Urologist Compliance With AUA Best Practice Guidelines for Benign Prostatic Hyperplasia in Medicare Population. Urology. 2011;78(1):3-9. doi:http://dx.doi.org/10.1016/j.urology.2010.12.087 CPT Codes for Identifying Imaging Events Label Intravenous pyelogram CT scan abdomen MRI abdomen Diagnostic ultrasound of abdomen Code 74400, 74405, 7441074425 74150-74170 74181-74183 76700, 76705, 76770, 5 76775 ICD-9 Codes for Including Imaging Events Label Hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptoms (LUTS) Hypertrophy (benign) of prostate with urinary obstruction and other lower urinary tract symptoms (LUTS) Hyperplasia of prostate, unspecified, with urinary obstruction and other lower urinary tract symptoms (LUTS) Retention of urine, unspecified Incomplete bladder emptying Urinary incontinence, unspecified Urge incontinence Urinary frequency Nocturia Slowing of urinary stream Code 600.00 600.01 600.91 788.20 788.21 788.30 788.31 788.41 788.43 788.62 ICD-9 and HCC Codes for Identifying Beneficiaries with “Red Flags” Label Chronic renal failure Nephritis, nephrotic syndrome, and nephrosis Other pyelonephritis or pyonephrosis not specified as acute or chronic Calculus of kidney and ureter Kidney stones Urinary tract infections Hematuria Fever Urinary retention Abdominal pain Cancer, except non-melanoma skin cancer Code ICD-9 403.01, 403.11, 403.91, 585.0-585.6, 585.9 ICD-9 580-589 ICD-9 590.80, 590.81 ICD-9 592 ICD-9 592.0 ICD-9 599.0 ICD-9 599.7x ICD-9 780.6x ICD-9 788.2x ICD-9 789.0x HCC 7-10 6 Don't order cardiac tests on low-risk, asymptomatic patients Choosing Wisely Guidelines American Academy of Family Physicians American College of Cardiology American College of Cardiology American College of Cardiology American College of Physicians American Society of Echocardiography Don’t order annual electrocardiograms (EKGs) or any other cardiac screening for low-risk patients without symptoms. There is little evidence that detection of coronary artery stenosis in asymptomatic patients at low risk for coronary heart disease improves health outcomes. False-positive tests are likely to lead to harm through unnecessary invasive procedures, over-treatment and misdiagnosis. Potential harms of this routine annual screening exceed the potential benefit. Don’t perform stress cardiac imaging or advanced non-invasive imaging in the initial evaluation of patients without cardiac symptoms unless high-risk markers are present. Asymptomatic, low-risk patients account for up to 45 percent of unnecessary “screening.” Testing should be performed only when the following findings are present: diabetes in patients older than 40-years-old; peripheral arterial disease; or greater than 2 percent yearly risk for coronary heart disease events. Don’t perform annual stress cardiac imaging or advanced noninvasive imaging as part of routine follow-up in asymptomatic patients. Performing stress cardiac imaging or advanced noninvasive imaging in patients without symptoms on a serial or scheduled pattern (e.g., every one to two years or at a heart procedure anniversary) rarely results in any meaningful change in patient management. This practice may, in fact, lead to unnecessary invasive procedures and excess radiation exposure without any proven impact on patients’ outcomes. An exception to this rule would be for patients more than five years after a bypass operation. Don’t perform echocardiography as routine follow-up for mild, asymptomatic native valve disease in adult patients with no change in signs or symptoms. Patients with native valve disease usually have years without symptoms before the onset of deterioration. An echocardiogram is not recommended yearly unless there is a change in clinical status. Don’t obtain screening exercise electrocardiogram testing in individuals who are asymptomatic and at low risk for coronary heart disease. In asymptomatic individuals at low risk for coronary heart disease (10-year risk <10%) screening for coronary heart disease with exercise electrocardiography does not improve patient outcomes. Avoid using stress echocardiograms on asymptomatic patients who meet “low risk” scoring criteria for coronary disease. Stress echocardiography is mostly used in symptomatic patients to assist in the diagnosis of obstructive coronary artery disease. There is very little information on using stress echocardiography in 7 American Society of Nuclear Cardiology American Society of Nuclear Cardiology American Society of Nuclear Cardiology Society of Cardiovascular Computed Tomography asymptomatic individuals for the purposes of cardiovascular risk assessment, as a stand-alone test or in addition to conventional risk factors. Don’t perform stress cardiac imaging or coronary angiography in patients without cardiac symptoms unless high-risk markers are present. Asymptomatic, low-risk patients account for up to 45 percent of inappropriate stress testing. Testing should be performed only when the following findings are present: diabetes in patients older than 40 years old, peripheral arterial disease, and greater than 2 percent yearly coronary heart disease event rate. Don’t perform cardiac imaging for patients who are at low risk. Chest pain patients at low risk of cardiac death and myocardial infarction (based on history, physical exam, electrocardiograms and cardiac biomarkers) do not merit stress radionuclide myocardial perfusion imaging or stress echocardiography as an initial testing strategy if they have a normal electrocardiogram (without baseline ST-abnormalities, left ventricular hypertrophy, pre-excitation, bundle branch block, intra-ventricular conduction delay, paced rhythm or on digoxin therapy) and are able to exercise. Don’t perform radionuclide imaging as part of routine follow-up in asymptomatic patients. Performing stress radionuclide imaging in patients without symptoms on a serial or scheduled pattern (e.g., every one to two years or at a heart procedure anniversary) rarely results in any meaningful change in patient management. This practice may lead to unnecessary invasive procedures and excess radiation exposure without any proven impact on patients’ outcomes. An exception to this rule would be for patients more than five years after a bypass operation. Don’t order coronary artery calcium scoring for screening purposes on low risk asymptomatic individuals except for those with a family history of premature coronary artery disease. Net reclassification of risk by coronary artery calcium scoring, when added to clinical risk scoring, is least effective in low risk individuals. Methods We calculated the percent of Medicare beneficiaries ages 66-80 with low cardiovascular risk who received a non-indicated electrocardiogram, cardiovascular stress test (including stress imaging), echocardiogram, or advanced cardiac imaging (CT, MRI, PET) in each calendar year 2006-11. We then created a weighted average of imaging prevalence for the interval 2006-11. We required enrollment in fee-for-service Medicare Parts A, B, and D for at least 11 months during the calendar year. We used HCC ICD-9 code lists to exclude beneficiaries at high risk for cardiac disease, requiring at least two physician claims or one acute hospital claim. We also assigned high-risk status using Part D prescription fill records and hospice billing: those patients with more than $200 in annual hospice billing were excluded from the low-risk cohort. We did not count testing events if diagnosis codes in any of the first four fields on a claim involved 8 cardiac disease, cardiac-related symptoms, or any conditions that might justify the test (e.g., respiratory conditions, cancer). References Physician Quality Reporting System (PQRS) Measure Specifications Manual for Claims and Registry Reporting of Individual Measures. Centers for Medicare and Medicaid Services. 2014. HCC Codes For Identifying High-Risk Patients Label HIV / AIDS Cancer Diabetes Drug / Alcohol Dependence Cardio-Respiratory Failure and Shock Congestive Heart Failure Acute Myocardial Infarction Unstable Angina and Other Acute Ischemic Heart Disease Angina Pectoris / Old Myocardial Infarction Specified Heart Arrhythmias Ischemic or Unspecified Stroke Hemiplegia / Hemiparesis Vascular Disease with Complications Vascular Disease Chronic Obstructive Pulmonary Disease Renal Failure Code 1 7-10 15-19 52 79 80 81 82 83 92 96 100 104 105 108 113 Drug Codes For Identifying High-Risk Patients Label Anticoagulants Platelet Aggregation Inhibitors Anti-Anginal Agents Diabetic Agents Peripheral Vasodilators Code D00519 D04136 D04698 D04744 D07137 D03812 D04114 D04865 D03889 D03041 D04786 D00252 D07385 D04291 D07356 D04659 D00022 D03811 D04382 D04258 D00213 D04316 D07409 D07721 D00514 D04315 D00666 D00268 D00269 D00321 D05719 D00393 D00394 D03846 D00162 D00042 D05529 D03864 D00246 D00248 D07767 D07466 D03807 D04110 D04743 D04442 D05488 D04267 D04434 D07467 D05896 D04122 D07963 D04697 D05436 D04538 D05278 D05765 D04370 D04373 D04369 D04371 D04372 D00213 D00902 D00693 CPT Codes for Identifying Cardiac Tests Label Advanced Imaging Code 0144T 0145T 0146T 0147T 0148T 0149T 0150T 75552 75553 9 (CT, MRI, PET) Cardiovascular Stress Test Echocardiogram Electrocardiogram 75554 75555 75556 75557 75558 75559 75561 75562 75565 75571 75572 75573 75574 78451 78452 78453 78454 78460 78461 78464 78465 78478 78480 78459 78481 78483 78491 78492 78494 78496 78499 75560 75563 75564 93015 93016 93017 93018 93024 93350 93351 93352 93303 93304 93306 93307 93308 93320 93321 93325 3120F 93000 93005 93010 G0366 G0367 G0368 G0403 G0404 G0405 ICD-9 Codes for Excluding Advanced Imaging (CT, MRI, PET) Advanced imaging tests were excluded from the analysis if the associated primary, secondary, tertiary, or quaternary diagnosis involved: (i) cardiac conditions; (ii) respiratory conditions, except acute respiratory infections (e.g. pneumonia); (iii) acute central nervous system conditions, except headaches; (iv) all thoracic and non-thoracic arterial conditions, but not peripheral venous conditions such as deep venous thrombosis; (v) malignant hypertension; (vi) end stage renal disease and acute renal disease; (vii) abdominal pain; (viii) cancer; (ix) drug toxicity or poisoning; or (x) exertional stress and fatigue. Label Unspecified septicemia Sarcoidosis Malignant neoplasm of upper lobe, bronchus, or lung Malignant neoplasm of bronchus and lung, unspecified site Malignant neoplasm of breast (female), unspecified site Malignant neoplasm of prostate Fluid overload Mitral stenosis Rheumatic mitral insufficiency Mitral stenosis with insufficiency Other and unspecified mitral valve diseases Rheumatic aortic stenosis Rheumatic aortic insufficiency Rheumatic aortic stenosis with insufficiency Other and unspecified rheumatic aortic diseases Mitral valve stenosis and aortic valve stenosis Mitral valve stenosis and aortic valve insufficiency Mitral valve insufficiency and aortic valve stenosis Mitral valve insufficiency and aortic valve insufficiency Multiple involvement of mitral and aortic valves Unspecified mitral and aortic valve diseases Diseases of tricuspid valve Rheumatic heart failure (congestive) Essential hypertension, malignant Malignant hypertensive heart disease without heart failure Code 0389 135 1623 1629 1749 185 2766 3940 3941 3942 3949 3950 3951 3952 3959 3960 3961 3962 3963 3968 3969 3970 39891 4010 40200 10 Malignant hypertensive heart disease with heart failure Benign hypertensive heart disease without heart failure Benign hypertensive heart disease with heart failure Unspecified hypertensive heart disease without heart failure Hypertensive heart disease, unspecified, with heart failure Hypertensive heart and chronic kidney disease, malignant, without heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, malignant, with heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, benign, without heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, benign, without heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, benign, with heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, unspecified, without heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, unspecified, with heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, unspecified, without heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, unspecified, with heart failure and with chronic kidney disease stage V Acute myocardial infarction of anterolateral wall, episode of care unspecified Acute myocardial infarction of anterolateral wall, initial episode of care Acute myocardial infarction of anterolateral wall, subsequent episode of care Acute myocardial infarction of other anterior wall, episode of care unspecified Acute myocardial infarction of other anterior wall, initial episode of care Acute myocardial infarction of other anterior wall, subsequent episode of care Acute myocardial infarction of inferolateral wall, episode of care unspecified Acute myocardial infarction of inferolateral wall, initial episode of care Acute myocardial infarction of inferolateral wall, subsequent episode of care Acute myocardial infarction of inferoposterior wall, episode of care unspecified Acute myocardial infarction of inferoposterior wall, initial episode of care Acute myocardial infarction of inferoposterior wall, subsequent episode of care Acute myocardial infarction of other inferior wall, episode of care unspecified Acute myocardial infarction of other inferior wall, initial episode of care Acute myocardial infarction of other inferior wall, subsequent episode of care Acute myocardial infarction of other lateral wall, episode of care unspecified Acute myocardial infarction of other lateral wall, initial episode of care Acute myocardial infarction of other lateral wall, subsequent episode of care 40201 40210 40211 40290 40291 40400 40401 40410 40412 40413 40490 40491 40492 40493 41000 41001 41002 41010 41011 41012 41020 41021 41022 41030 41031 41032 41040 41041 41042 41050 41051 41052 11 Acute myocardial infarction, subendocardial infarction, episode of care unspecified Acute myocardial infarction, subendocardial infarction, initial episode of care Acute myocardial infarction, subendocardial infarction, subsequent episode of care Acute myocardial infarction of other specified sites, episode of care unspecified Acute myocardial infarction of other specified sites, initial episode of care Acute myocardial infarction of other specified sites, subsequent episode of care Acute myocardial infarction, unspecified site, episode of care unspecified Acute myocardial infarction, unspecified site, initial episode of care Acute myocardial infarction, unspecified site, subsequent episode of care Postmyocardial infarction syndrome Intermediate coronary syndrome Acute coronary occlusion without myocardial infarction Other acute and subacute form of ischemic heart disease Old myocardial infarction Angina decubitus Prinzmetal angina Other and unspecified angina pectoris Coronary atherosclerosis of unspecified type of vessel, native or graft Coronary atherosclerosis of native coronary artery Coronary atherosclerosis of autologous vein bypass graft Coronary atherosclerosis of nonautologous biological bypass graft Coronary atherosclerosis of artery bypass graft Coronary atherosclerosis of unspecified type of bypass graft Coronary atherosclerosis, of native coronary artery of transplanted heart Coronary atherosclerosis, of bypass graft (artery) (vein) of transplanted heart Aneurysm of heart Aneurysm of coronary vessels Other aneurysm of heart Chronic total occlusion of coronary artery Coronary atherosclerosis due to lipid rich plaque Other specified forms of chronic ischemic heart disease Unspecified chronic ischemic heart disease Iatrogenic pulmonary embolism and infarction Other pulmonary embolism and infarction Primary pulmonary hypertension Other chronic pulmonary heart diseases Unspecified chronic pulmonary heart disease Unspecified acute pericarditis Acute idiopathic pericarditis Acute and subacute bacterial endocarditis 41070 41071 41072 41080 41081 41082 41090 41091 41092 4110 4111 41181 41189 412 4130 4131 4139 41400 41401 41402 41403 41404 41405 41406 41407 41410 41411 41419 4142 4143 4148 4149 41511 41519 4160 4168 4169 42090 42091 4210 12 Other specified diseases of pericardium Unspecified disease of pericardium Mitral valve disorders Aortic valve disorders Tricuspid valve disorders, specified as nonrheumatic Pulmonary valve disorders Endocarditis, valve unspecified, unspecified cause Endomyocardial fibrosis Hypertrophic obstructive cardiomyopathy Other primary cardiomyopathies Alcoholic cardiomyopathy Cardiomyopathy in other diseases classified elsewhere Unspecified secondary cardiomyopathy Atrioventricular block, complete Unspecified atrioventricular block First degree atrioventricular block Mobitz (type) II atrioventricular block Other second degree atrioventricular block Left bundle branch hemiblock Other left bundle branch block Right bundle branch block Unspecified bundle branch block Right bundle branch block and left posterior fascicular block Right bundle branch block and left anterior fascicular block Other bilateral bundle branch block Other heart block Anomalous atrioventricular excitation Long QT syndrome Other specified conduction disorder Unspecified conduction disorder Paroxysmal supraventricular tachycardia Paroxysmal ventricular tachycardia Unspecified paroxysmal tachycardia Atrial fibrillation Atrial flutter Ventricular fibrillation Ventricular flutter Cardiac arrest Unspecified premature beats Supraventricular premature beats Other premature beats Sinoatrial node dysfunction Other specified cardiac dysrhythmias Unspecified cardiac dysrhythmia 4238 4239 4240 4241 4242 4243 42490 4250 4251 4254 4255 4258 4259 4260 42610 42611 42612 42613 4262 4263 4264 42650 42651 42652 42653 4266 4267 42682 42689 4269 4270 4271 4272 42731 42732 42741 42742 4275 42760 42761 42769 42781 42789 4279 13 Congestive heart failure, unspecified Left heart failure Unspecified systolic heart failure Acute systolic heart failure Chronic systolic heart failure Acute on chronic systolic heart failure Unspecified diastolic heart failure Acute diastolic heart failure Chronic diastolic heart failure Acute on chronic diastolic heart failure Unspecified combined systolic and diastolic heart failure Acute combined systolic and diastolic heart failure Chronic combined systolic and diastolic heart failure Acute on chronic combined systolic and diastolic heart failure Unspecified heart failure Unspecified myocarditis Myocardial degeneration Unspecified cardiovascular disease Cardiomegaly Functional disturbances following cardiac surgery Acquired cardiac septal defect Other disorders of papillary muscle Hyperkinetic heart disease Other ill-defined heart disease Unspecified heart disease Occlusion and stenosis of carotid artery without mention of cerebral infarction Occlusion and stenosis of carotid artery with cerebral infarction Occlusion and stenosis of multiple and bilateral precerebral arteries without mention of c Cerebral embolism with cerebral infarction Unspecified cerebral artery occlusion without mention of cerebral infarction Unspecified cerebral artery occlusion with cerebral infarction Other specified transient cerebral ischemias Unspecified transient cerebral ischemia Acute, but ill-defined, cerebrovascular disease Cerebral atherosclerosis Atherosclerosis of aorta Atherosclerosis of renal artery Atherosclerosis of native arteries of the extremities, unspecified Atherosclerosis of native arteries of the extremities with intermittent claudication Atherosclerosis of native arteries of the extremities with rest pain Atherosclerosis of native arteries of the extremities with ulceration 4280 4281 42820 42821 42822 42823 42830 42831 42832 42833 42840 42841 42842 42843 4289 4290 4291 4292 4293 4294 42971 42981 42982 42989 4299 43310 43311 43330 43411 43490 43491 4358 4359 436 4370 4400 4401 44020 44021 44022 44023 14 Atherosclerosis of native arteries of the extremities with gangrene Atherosclerosis of other specified arteries Generalized and unspecified atherosclerosis Dissecting aortic aneurysm (any part), unspecified site Dissecting aortic aneurysm (any part), thoracic Dissecting aortic aneurysm (any part), abdominal Thoracic aneurysm without mention of rupture Abdominal aneurysm without mention of rupture Thoracoabdominal aneurysm without mention of rupture Aortic aneurysm of unspecified site without mention of rupture Other peripheral vascular disease Embolism and thrombosis of arteries of lower extremity Stricture of artery Other specified disorders of arteries and arterioles Unspecified disorders of arteries and arterioles Orthostatic hypotension Other iatrogenic hypotension Unspecified hypotension Obstructive chronic bronchitis, without exacerbation Obstructive chronic bronchitis, with (acute) exacerbation Other emphysema Chronic obstructive asthma, unspecified Chronic obstructive asthma, with (acute) exacerbation Asthma, unspecified, unspecified status Asthma, unspecified, with (acute) exacerbation Chronic airway obstruction, not elsewhere classified Pleurisy without mention of effusion or current tuberculosis Unspecified pleural effusion Pulmonary congestion and hypostasis Postinflammatory pulmonary fibrosis Unspecified acute edema of lung Acute respiratory failure Other pulmonary insufficiency, not elsewhere classified Acute and chronic respiratory failure Other diseases of lung, not elsewhere classified Unspecified disease of the jaws Acute cholecystitis Acute pancreatitis Unspecified acute renal failure End stage renal disease Difficulty in walking Lumbago Unspecified backache Muscle weakness (generalized) 44024 4408 4409 44100 44101 44102 4412 4414 4417 4419 44389 44422 4471 4478 4479 4580 45829 4589 49120 49121 4928 49320 49322 49390 49392 496 5110 5119 514 515 5184 51881 51882 51884 51889 5269 5750 5770 5849 5856 7197 7242 7245 72887 15 Unspecified myalgia and myositis Swelling of limb Tietze's disease Tetralogy of Fallot Ventricular septal defect Ostium secundum type atrial septal defect Congenital stenosis of aortic valve Congenital insufficiency of aortic valve Congenital mitral insufficiency Congenital coronary artery anomaly Other specified congenital anomaly of heart Unspecified congenital anomaly of heart Congenital atresia and stenosis of aorta Transient alteration of awareness Other alteration of consciousness Syncope and collapse Altered mental status Edema Jaw pain Unspecified tachycardia Palpitations Undiagnosed cardiac murmurs Other abnormal heart sounds Unspecified shock Cardiogenic shock Other shock without mention of trauma Other symptoms involving cardiovascular system Unspecified respiratory abnormality Orthopnea Shortness of breath Tachypnea Wheezing Other dyspnea and respiratory abnormalities Chest pain, unspecified Precordial pain Painful respiration Chest pain, other Other symptoms involving respiratory system and chest Abdominal pain, unspecified site Abdominal pain, right upper quadrant Abdominal pain, epigastric Abdominal pain, generalized Abdominal pain, other specified site Other nonspecific abnormal serum enzyme levels 7291 72981 7336 7452 7454 7455 7463 7464 7466 74685 74689 7469 74722 78002 78009 7802 78097 7823 78492 7850 7851 7852 7853 78550 78551 78559 7859 78600 78602 78605 78606 78607 78609 78650 78651 78652 78659 7869 78900 78901 78906 78907 78909 7905 16 Nonspecific abnormal findings on radiological and other examination of lung field Nonspecific abnormal results of pulmonary system function study Nonspecific abnormal unspecified cardiovascular function study Nonspecific abnormal electrocardiogram (ECG) (EKG) Other nonspecific abnormal cardiovascular system function study Hypoxemia Mechanical complication due to cardiac pacemaker (electrode) Mechanical complication due to coronary bypass graft Other complications due to other cardiac device, implant, and graft Complications of transplanted heart Cardiac complications Unspecified circulatory disease Personal history of other diseases of circulatory system Personal history of surgery to heart and great vessels, presenting hazards to health Kidney replaced by transplant Heart replaced by transplant Heart valve replaced by transplant Heart valve replaced by other means Cardiac pacemaker in situ Automatic implantable cardiac defibrillator in situ Postprocedural aortocoronary bypass status Postprocedural percutaneous transluminal coronary angioplasty status Other cardiorespiratory problems Awaiting organ transplant status Fitting and adjustment of cardiac pacemaker Encounter for antineoplastic chemotherapy Aftercare following organ transplant Encounter for long-term (current) use of other medications Encounter for therapeutic drug monitoring Follow-up examination following completed treatment with high-risk medications, not elsewhere classified Observation for suspected cardiovascular disease 7931 7942 79430 79431 79439 79902 99601 99603 99672 99683 9971 V1250 V1259 V151 V420 V421 V422 V433 V4501 V4502 V4581 V4582 V472 V4983 V5331 V5811 V5844 V5869 V5883 V6751 V717 ICD-9 Codes for Excluding Cardiovascular Stress Tests See advanced imaging criteria. ICD-9 Codes for Excluding Echocardiograms Echocardiograms were excluded from the analysis if the associated primary, secondary, tertiary, or quaternary diagnosis involved: (i) proximal fractures; (ii) pulmonary and chest conditions, including anything potentially resulting in chest pain (e.g., chest wall contusion); (iii) esophageal conditions (e.g., esophagitis and esophageal spasm), except those that are painless, mild, and 17 chronic (e.g., esophageal stricture, Barrett’s esophagus, and reflux); (iv) cardiac conditions, including shortness of breath, edema, congestive heart failure and anatomic anomalies; (v) end stage renal disease and dialysis, along with all electrolyte abnormalities; (vi) infections, including sepsis, but not urinary tract infections or pneumonia; (vii) anemia and bleeding conditions, except microscopic hematuria; (viii) abdominal conditions (including abdominal pain), but not benign tumor of the colon; (ix) psychiatric conditions; (x) acute central nervous system conditions (e.g., cerebrovascular accident, delirium) and seizure or epilepsy conditions, but not chronic conditions (e.g., dementia), head ache, or migraine; (xi) drug toxicity and poisoning; (xii) transplants; (xiii) malignant hypertension; (xiv) cancers; (xv) conditions involving arterial and pulmonary emboli, but not peripheral deep vein thrombosis; (xvi) falls; (xvii) autoimmune conditions; or (xviii) pain in the anterior and posterior thorax and shoulder areas (eg. back pain), but not specific shoulder conditions such as “capsular adhesion of shoulder” and “osteoarthrosis of shoulder.” Label Streptococcal septicemia Unspecified staphylococcal septicemia Methicillin susceptible Staphylococcus aureus septicemia Methicillin resistant Staphylococcus aureus septicemia Other staphylococcal septicemia Pneumococcal septicemia Septicemia due to anaerobes Septicemia due to unspecified gram-negative organism Septicemia due to Escherichia coli (E. coli) Septicemia due to pseudomonas Other septicemia due to gram-negative organism Other specified septicemia Unspecified septicemia Methicillin susceptible Staphylococcus aureus Methicillin resistant Staphylococcus aureus Human immunodeficiency virus [HIV] Candidal endocarditis Other and unspecified mycoses Sarcoidosis Unspecified infectious and parasitic diseases Malignant neoplasm of esophagus, unspecified site Malignant neoplasm of cardia Malignant neoplasm of stomach, unspecified site Malignant neoplasm of hepatic flexure Malignant neoplasm of transverse colon Malignant neoplasm of descending colon Malignant neoplasm of sigmoid colon Malignant neoplasm of cecum Malignant neoplasm of ascending colon Malignant neoplasm of colon, unspecified site Code 0380 03810 03811 03812 03819 0382 0383 03840 03842 03843 03849 0388 0389 04111 04112 042 11281 1179 135 1369 1509 1510 1519 1530 1531 1532 1533 1534 1536 1539 18 Malignant neoplasm of rectosigmoid junction Malignant neoplasm of rectum Malignant neoplasm of liver, primary Malignant neoplasm of head of pancreas Malignant neoplasm of pancreas, part unspecified Malignant neoplasm of main bronchus Malignant neoplasm of upper lobe, bronchus, or lung Malignant neoplasm of middle lobe, bronchus, or lung Malignant neoplasm of lower lobe, bronchus, or lung Malignant neoplasm of other parts of bronchus or lung Malignant neoplasm of bronchus and lung, unspecified site Malignant neoplasm of heart Malignant neoplasm of central portion of female breast Malignant neoplasm of upper-outer quadrant of female breast Malignant neoplasm of other specified sites of female breast Malignant neoplasm of breast (female), unspecified site Malignant neoplasm of corpus uteri, except isthmus Malignant neoplasm of ovary Malignant neoplasm of prostate Malignant neoplasm of other specified sites of bladder Malignant neoplasm of bladder, part unspecified Malignant neoplasm of kidney, except pelvis Secondary malignant neoplasm of lung Secondary malignant neoplasm of pleura Secondary malignant neoplasm of retroperitoneum and peritoneum Secondary malignant neoplasm of liver Secondary malignant neoplasm of brain and spinal cord Secondary malignant neoplasm of bone and bone marrow Secondary malignant neoplasm of other specified sites Other malignant neoplasm of unspecified site Hodgkin's disease, unspecified type, unspecified site, extranodal and solid organ sites Nodular lymphoma, unspecified site, extranodal and solid organ sites Other malignant lymphomas, unspecified site, extranodal and solid organ sites Other malignant lymphomas of lymph nodes of head, face, and neck Other malignant lymphomas of intra-abdominal lymph nodes Other malignant lymphomas of lymph nodes of multiple sites Multiple myeloma, without mention of having achieved remission Acute lymphoid leukemia, without mention of having achieved remission Chronic lymphoid leukemia, without mention of having achieved remission Acute myeloid leukemia, without mention of having achieved remission Chronic myeloid leukemia, without mention of having achieved remission Unspecified leukemia, without mention of having achieved remission 1540 1541 1550 1570 1579 1622 1623 1624 1625 1628 1629 1641 1741 1744 1748 1749 1820 1830 185 1888 1889 1890 1970 1972 1976 1977 1983 1985 19889 1991 20190 20200 20280 20281 20283 20288 20300 20400 20410 20500 20510 20890 19 Benign neoplasm of heart Carcinoma in situ of bronchus and lung Carcinoma in situ of breast Myelodysplastic syndrome, unspecified Neoplasm of uncertain behavior of other specified sites Neoplasm of uncertain behavior, site unspecified Neoplasm of unspecified nature of digestive system Neoplasm of unspecified nature of respiratory system Neoplasm of unspecified nature of breast Neoplasm of unspecified nature of brain Neoplasm of unspecified nature of other specified sites Neoplasms Of Unspecified Nature, Other Specified Sites Neoplasm of unspecified nature, site unspecified Carcinoid syndrome Volume depletion, unspecified Fluid overload Fluid Overload NEC (Other Fluid Overload) Amyloidosis Amyloidosis, unspecified Other amyloidosis Autoimmune disease, not elsewhere classified Sickle-cell disease, unspecified Hb-SS disease with crisis Drug-induced delirium Delirium due to conditions classified elsewhere Carotid sinus syndrome Encephalopathy, unspecified Metabolic encephalopathy Other encephalopathy Toxic encephalopathy Myasthenia gravis with (acute) exacerbation Hereditary progressive muscular dystrophy Unspecified retinal vascular occlusion Central artery occlusion of retina Arterial branch occlusion of retina Partial arterial occlusion of retina Transient arterial occlusion of retina Sudden visual loss Rheumatic fever without mention of heart involvement Acute rheumatic pericarditis Acute rheumatic endocarditis Other acute rheumatic heart disease Unspecified acute rheumatic heart disease 2127 2312 2330 23875 2388 2389 2390 2391 2393 2396 2398 23989 2399 2592 27650 2766 27669 2773 27730 27739 2794 28260 28262 29281 2930 33701 34830 34831 34839 34982 35801 3591 36230 36231 36232 36233 36234 36811 390 3910 3911 3918 3919 20 Chronic rheumatic pericarditis Mitral stenosis Rheumatic mitral insufficiency Mitral stenosis with insufficiency Other and unspecified mitral valve diseases Rheumatic aortic stenosis Rheumatic aortic insufficiency Rheumatic aortic stenosis with insufficiency Other and unspecified rheumatic aortic diseases Mitral valve stenosis and aortic valve stenosis Mitral valve stenosis and aortic valve insufficiency Mitral valve insufficiency and aortic valve stenosis Mitral valve insufficiency and aortic valve insufficiency Multiple involvement of mitral and aortic valves Unspecified mitral and aortic valve diseases Diseases of tricuspid valve Rheumatic diseases of pulmonary valve Rheumatic diseases of endocardium, valve unspecified Rheumatic myocarditis Unspecified rheumatic heart disease Rheumatic heart failure (congestive) Other and unspecified rheumatic heart diseases Malignant hypertensive heart disease without heart failure Malignant hypertensive heart disease with heart failure Benign hypertensive heart disease without heart failure Benign hypertensive heart disease with heart failure Hypertensive heart disease, unspecified, with heart failure Hypertensive chronic kidney disease, benign, with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, malignant, without heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, malignant, with heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, malignant, without heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, malignant, with heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, benign, without heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, benign, with heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, benign, without heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, benign, with heart failure and with chronic kidney disease stage V 393 3940 3941 3942 3949 3950 3951 3952 3959 3960 3961 3962 3963 3968 3969 3970 3971 3979 3980 39890 39891 39899 40200 40201 40210 40211 40291 40310 40400 40401 40402 40403 40410 40411 40412 40413 21 Hypertensive heart and chronic kidney disease, unspecified, without heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, unspecified, with heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, unspecified, without heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, unspecified, with heart failure and with chronic kidney disease stage V Secondary renovascular hypertension, malignant Secondary renovascular hypertension, benign Acute myocardial infarction of anterolateral wall, episode of care unspecified Acute myocardial infarction of anterolateral wall, initial episode of care Acute myocardial infarction of anterolateral wall, subsequent episode of care Acute myocardial infarction of other anterior wall, episode of care unspecified Acute myocardial infarction of other anterior wall, initial episode of care Acute myocardial infarction of other anterior wall, subsequent episode of care Acute myocardial infarction of inferolateral wall, episode of care unspecified Acute myocardial infarction of inferolateral wall, initial episode of care Acute myocardial infarction of inferolateral wall, subsequent episode of care Acute myocardial infarction of inferoposterior wall, episode of care unspecified Acute myocardial infarction of inferoposterior wall, initial episode of care Acute myocardial infarction of inferoposterior wall, subsequent episode of care Acute myocardial infarction of other inferior wall, episode of care unspecified Acute myocardial infarction of other inferior wall, initial episode of care Acute myocardial infarction of other inferior wall, subsequent episode of care Acute myocardial infarction of other lateral wall, episode of care unspecified Acute myocardial infarction of other lateral wall, initial episode of care Acute myocardial infarction of other lateral wall, subsequent episode of care Acute myocardial infarction, true posterior wall infarction, episode of care unspecified Acute myocardial infarction, true posterior wall infarction, initial episode of care Acute myocardial infarction, true posterior wall infarction, subsequent episode of care Acute myocardial infarction, subendocardial infarction, episode of care unspecified Acute myocardial infarction, subendocardial infarction, initial episode of care Acute myocardial infarction, subendocardial infarction, subsequent episode of care Acute myocardial infarction of other specified sites, episode of care unspecified Acute myocardial infarction of other specified sites, initial episode of care Acute myocardial infarction of other specified sites, subsequent episode of care Acute myocardial infarction, unspecified site, episode of care unspecified Acute myocardial infarction, unspecified site, initial episode of care Acute myocardial infarction, unspecified site, subsequent episode of care 40490 40491 40492 40493 40501 40511 41000 41001 41002 41010 41011 41012 41020 41021 41022 41030 41031 41032 41040 41041 41042 41050 41051 41052 41060 41061 41062 41070 41071 41072 41080 41081 41082 41090 41091 41092 22 Postmyocardial infarction syndrome Intermediate coronary syndrome Acute coronary occlusion without myocardial infarction Other acute and subacute form of ischemic heart disease Old myocardial infarction Angina decubitus Prinzmetal angina Other and unspecified angina pectoris Coronary atherosclerosis of unspecified type of vessel, native or graft Coronary atherosclerosis of native coronary artery Coronary atherosclerosis of autologous vein bypass graft Coronary atherosclerosis of nonautologous biological bypass graft Coronary atherosclerosis of artery bypass graft Coronary atherosclerosis of unspecified type of bypass graft Coronary atherosclerosis, of native coronary artery of transplanted heart Coronary atherosclerosis, of bypass graft (artery) (vein) of transplanted heart Aneurysm of heart Aneurysm of coronary vessels Dissection of coronary artery Other aneurysm of heart Chronic total occlusion of coronary artery Coronary atherosclerosis due to lipid rich plaque Other specified forms of chronic ischemic heart disease Unspecified chronic ischemic heart disease Acute cor pulmonale Iatrogenic pulmonary embolism and infarction Septic pulmonary embolism Other pulmonary embolism and infarction Primary pulmonary hypertension Kyphoscoliotic heart disease Chronic pulmonary embolism Other chronic pulmonary heart diseases Unspecified chronic pulmonary heart disease Arteriovenous fistula of pulmonary vessels Aneurysm of pulmonary artery Other specified disease of pulmonary circulation Unspecified disease of pulmonary circulation Acute pericarditis in diseases classified elsewhere Unspecified acute pericarditis Acute idiopathic pericarditis Other acute pericarditis Acute and subacute bacterial endocarditis Acute and subacute infective endocarditis in diseases classified elsewhere 4110 4111 41181 41189 412 4130 4131 4139 41400 41401 41402 41403 41404 41405 41406 41407 41410 41411 41412 41419 4142 4143 4148 4149 4150 41511 41512 41519 4160 4161 4162 4168 4169 4170 4171 4178 4179 4200 42090 42091 42099 4210 4211 23 Unspecified acute endocarditis Acute myocarditis in diseases classified elsewhere Unspecified acute myocarditis Idiopathic myocarditis Septic myocarditis Toxic myocarditis Hemopericardium Adhesive pericarditis Constrictive pericarditis Cardiac tamponade Other specified diseases of pericardium Unspecified disease of pericardium Mitral valve disorders Aortic valve disorders Tricuspid valve disorders, specified as nonrheumatic Pulmonary valve disorders Endocarditis, valve unspecified, unspecified cause Endocarditis in diseases classified elsewhere Other endocarditis, valve unspecified Endomyocardial fibrosis Hypertrophic obstructive cardiomyopathy Hypertrophic obstructive cardiomyopathy Other hypertrophic cardiomyopathy Obscure cardiomyopathy of Africa Endocardial fibroelastosis Other primary cardiomyopathies Alcoholic cardiomyopathy Nutritional and metabolic cardiomyopathy Cardiomyopathy in other diseases classified elsewhere Unspecified secondary cardiomyopathy Atrioventricular block, complete Unspecified atrioventricular block First degree atrioventricular block Mobitz (type) II atrioventricular block Other second degree atrioventricular block Left bundle branch hemiblock Other left bundle branch block Right bundle branch block Unspecified bundle branch block Right bundle branch block and left posterior fascicular block Right bundle branch block and left anterior fascicular block Other bilateral bundle branch block Trifascicular block 4219 4220 42290 42291 42292 42293 4230 4231 4232 4233 4238 4239 4240 4241 4242 4243 42490 42491 42499 4250 4251 42511 42518 4252 4253 4254 4255 4257 4258 4259 4260 42610 42611 42612 42613 4262 4263 4264 42650 42651 42652 42653 42654 24 Other heart block Anomalous atrioventricular excitation Long QT syndrome Other specified conduction disorder Unspecified conduction disorder Paroxysmal supraventricular tachycardia Paroxysmal ventricular tachycardia Unspecified paroxysmal tachycardia Atrial fibrillation Atrial flutter Ventricular fibrillation Ventricular flutter Cardiac arrest Unspecified premature beats Supraventricular premature beats Other premature beats Sinoatrial node dysfunction Other specified cardiac dysrhythmias Unspecified cardiac dysrhythmia Congestive heart failure, unspecified Left heart failure Unspecified systolic heart failure Acute systolic heart failure Chronic systolic heart failure Acute on chronic systolic heart failure Unspecified diastolic heart failure Acute diastolic heart failure Chronic diastolic heart failure Acute on chronic diastolic heart failure Unspecified combined systolic and diastolic heart failure Acute combined systolic and diastolic heart failure Chronic combined systolic and diastolic heart failure Acute on chronic combined systolic and diastolic heart failure Unspecified heart failure Unspecified myocarditis Myocardial degeneration Unspecified cardiovascular disease Cardiomegaly Functional disturbances following cardiac surgery Rupture of chordae tendineae Rupture of papillary muscle Acquired cardiac septal defect Other certain sequelae of myocardial infarction, not elsewhere classified 4266 4267 42682 42689 4269 4270 4271 4272 42731 42732 42741 42742 4275 42760 42761 42769 42781 42789 4279 4280 4281 42820 42821 42822 42823 42830 42831 42832 42833 42840 42841 42842 42843 4289 4290 4291 4292 4293 4294 4295 4296 42971 42979 25 Other disorders of papillary muscle Hyperkinetic heart disease Takotsubo syndrome Other ill-defined heart disease Unspecified heart disease Intracerebral hemorrhage Unspecified intracranial hemorrhage Occlusion and stenosis of basilar artery without mention of cerebral infarction Occlusion and stenosis of basilar artery with cerebral infarction Occlusion and stenosis of carotid artery without mention of cerebral infarction Occlusion and stenosis of carotid artery with cerebral infarction Occlusion and stenosis of multiple and bilateral precerebral arteries without mention of cerebral infarction Occlusion and stenosis of multiple and bilateral precerebral arteries with cerebral infarction Occlusion and stenosis of unspecified precerebral artery without mention of cerebral infarction Occlusion and stenosis of unspecified precerebral artery with cerebral infarction Cerebral thrombosis without mention of cerebral infarction Cerebral thrombosis with cerebral infarction Cerebral embolism without mention of cerebral infarction Cerebral embolism with cerebral infarction Unspecified cerebral artery occlusion without mention of cerebral infarction Unspecified cerebral artery occlusion with cerebral infarction Basilar artery syndrome Vertebral artery syndrome Subclavian steal syndrome Vertebrobasilar artery syndrome Other specified transient cerebral ischemias Unspecified transient cerebral ischemia Acute, but ill-defined, cerebrovascular disease Other generalized ischemic cerebrovascular disease Hypertensive encephalopathy Transient global amnesia Unspecified cerebrovascular disease Hemiplegia affecting unspecified side due to cerebrovascular disease Atherosclerosis of aorta Atherosclerosis of native arteries of the extremities, unspecified Atherosclerosis of native arteries of the extremities with intermittent claudication Atherosclerosis of native arteries of the extremities with rest pain Atherosclerosis of native arteries of the extremities with ulceration Atherosclerosis of native arteries of the extremities with gangrene 42981 42982 42983 42989 4299 431 4329 43300 43301 43310 43311 43330 43331 43390 43391 43400 43401 43410 43411 43490 43491 4350 4351 4352 4353 4358 4359 436 4371 4372 4377 4379 43820 4400 44020 44021 44022 44023 44024 26 Other atherosclerosis of native arteries of the extremities Generalized and unspecified atherosclerosis Dissecting aortic aneurysm (any part), unspecified site Dissecting aortic aneurysm (any part), thoracic Dissecting aortic aneurysm (any part), abdominal Dissecting aortic aneurysm (any part), thoracoabdominal Thoracic aneurysm, ruptured Thoracic aneurysm without mention of rupture Abdominal aneurysm, ruptured Abdominal aneurysm without mention of rupture Aortic aneurysm of unspecified site, ruptured Thoracoabdominal aneurysm, ruptured Thoracoabdominal aneurysm without mention of rupture Aortic aneurysm of unspecified site without mention of rupture Aneurysm of iliac artery Aneurysm of artery of lower extremity Aneurysm of artery of neck Other aneurysm of unspecified site Thromboangiitis obliterans (Buerger's disease) Peripheral angiopathy in diseases classified elsewhere Embolism and thrombosis of abdominal aorta Embolism and thrombosis of thoracic aorta Embolism and thrombosis of arteries of upper extremity Embolism and thrombosis of arteries of lower extremity Embolism and thrombosis of iliac artery Embolism and thrombosis of other specified artery Embolism and thrombosis of unspecified artery Atheroembolism of other site Giant cell arteritis Takayasu's disease Stricture of artery Unspecified arteritis Aortic ectasia unspecified site Thoracic aortic ectasia Other specified disorders of arteries and arterioles Unspecified disorders of arteries and arterioles Embolism and thrombosis of vena cava Venous embolism and thrombosis of unspecified deep vessels of lower extremity Venous embolism and thrombosis of deep vessels of proximal lower extremity Venous embolism and thrombosis of deep vessels of distal lower extremity Venous embolism and thrombosis of other specified veins Embolism and thrombosis of unspecified site 44029 4409 44100 44101 44102 44103 4411 4412 4413 4414 4415 4416 4417 4419 4422 4423 44281 4429 4431 44381 4440 4441 44421 44422 44481 44489 4449 44589 4465 4467 4471 4476 44770 44771 4478 4479 4532 45340 45341 45342 4538 4539 27 Orthostatic hypotension Chronic hypotension Hypotension of hemodialysis Other iatrogenic hypotension Other specified hypotension Unspecified hypotension Other specified circulatory system disorders Unspecified circulatory system disorder Acute upper respiratory infections of unspecified site Methicillin susceptible pneumonia due to Staphylococcus aureus Obstructive chronic bronchitis, with (acute) exacerbation Obstructive chronic bronchitis with acute bronchitis Extrinsic asthma, unspecified Intrinsic asthma, unspecified Chronic obstructive asthma, unspecified Chronic obstructive asthma with status asthmaticus Chronic obstructive asthma, with (acute) exacerbation Asthma, unspecified, unspecified status Asthma, unspecified with status asthmaticus Asthma, unspecified, with (acute) exacerbation Bronchiectasis with acute exacerbation Chronic airway obstruction, not elsewhere classified Empyema without mention of fistula Pleurisy without mention of effusion or current tuberculosis Pleurisy with effusion, with mention of bacterial cause other than tuberculosis Other specified forms of pleural effusion, except tuberculous Malignant pleural effusion Other specified forms of effusion, except tuberculous Unspecified pleural effusion Other spontaneous pneumothorax Abscess of lung Pulmonary congestion and hypostasis Postinflammatory pulmonary fibrosis Idiopathic fibrosing alveolitis Other specified alveolar and parietoalveolar pneumonopathies Pulmonary collapse Unspecified acute edema of lung Pulmonary insufficiency following trauma and surgery Acute respiratory failure Other pulmonary insufficiency, not elsewhere classified Chronic respiratory failure Acute and chronic respiratory failure Other diseases of lung, not elsewhere classified 4580 4581 45821 45829 4588 4589 45989 4599 4659 48241 49121 49122 49300 49310 49320 49321 49322 49390 49391 49392 4941 496 5109 5110 5111 5118 51181 51189 5119 5128 5130 514 515 5163 5168 5180 5184 5185 51881 51882 51883 51884 51889 28 Acute bronchospasm Unspecified disease of respiratory system Acute vascular insufficiency of intestine Unspecified vascular insufficiency of intestine Diverticulosis of colon with hemorrhage Hemoperitoneum (nontraumatic) Hepatic coma Acute pancreatitis Acute renal failure with lesion of tubular necrosis Unspecified acute renal failure End stage renal disease Suspected damage to fetus from drugs, affecting management of mother, antepartum condition or complication Other known or suspected fetal abnormality, not elsewhere classified, affecting management of mother, antepartum condition or complication Unspecified fetal abnormality affecting management of mother, antepartum condition or complication Systemic lupus erythematosus Systemic sclerosis Rheumatoid arthritis Effusion of lower leg joint Pain in thoracic spine Swelling of limb Tietze's disease Bulbus cordis anomalies and anomalies of cardiac septal closure, common truncus Complete transposition of great vessels Transposition of great vessels, double outlet right ventricle Corrected transposition of great vessels Other transposition of great vessels Tetralogy of Fallot Bulbus cordis anomalies and anomalies of cardiac septal closure, common ventricle Ventricular septal defect Ostium secundum type atrial septal defect Unspecified type congenital endocardial cushion defect Ostium primum defect Other congenital endocardial cushion defect Other bulbus cordis anomalies and anomalies of cardiac septal closure Unspecified congenital defect of septal closure Unspecified congenital pulmonary valve anomaly Congenital atresia of pulmonary valve Congenital stenosis of pulmonary valve Other congenital anomalies of pulmonary valve 51911 5199 5570 5579 56212 56881 5722 5770 5845 5849 5856 65553 65583 65593 7100 7101 7140 71906 7241 72981 7336 7450 74510 74511 74512 74519 7452 7453 7454 7455 74560 74561 74569 7458 7459 74600 74601 74602 74609 29 Congenital tricuspid atresia and stenosis Ebstein's anomaly Congenital stenosis of aortic valve Congenital insufficiency of aortic valve Congenital mitral stenosis Congenital mitral insufficiency Hypoplastic left heart syndrome Congenital subaortic stenosis Congenital obstructive anomalies of heart, not elsewhere classified Congenital coronary artery anomaly Congenital heart block Congenital malposition of heart and cardiac apex Other specified congenital anomaly of heart Unspecified congenital anomaly of heart Patent ductus arteriosus Coarctation of aorta (preductal) (postductal) Unspecified congenital anomaly of aorta Congenital anomaly of aortic arch Congenital atresia and stenosis of aorta Other congenital anomaly of aorta Congenital anomalies of pulmonary artery Partial congenital anomalous pulmonary venous connection Down's syndrome Marfan's syndrome Other specified multiple congenital anomalies, so described Coma Transient alteration of awareness Other alteration of consciousness Syncope and collapse Dizziness and giddiness Fever and other physiologic disturbances of temperature regulation Fever, unspecified Fever presenting with conditions classified elsewhere Chronic fatigue syndrome Memory loss Altered mental status Edema Cyanosis Unspecified tachycardia Palpitations Undiagnosed cardiac murmurs Other abnormal heart sounds Gangrene 7461 7462 7463 7464 7465 7466 7467 74681 74684 74685 74686 74687 74689 7469 7470 74710 74720 74721 74722 74729 7473 74742 7580 75982 75989 78001 78002 78009 7802 7804 7806 78060 78061 78071 78093 78097 7823 7825 7850 7851 7852 7853 7854 30 Unspecified shock Cardiogenic shock Septic shock Other shock without mention of trauma Other symptoms involving cardiovascular system Unspecified respiratory abnormality Apnea Cheyne-Stokes respiration Shortness of breath Tachypnea Wheezing Other dyspnea and respiratory abnormalities Hemoptysis Chest pain, unspecified Precordial pain Painful respiration Chest pain, other Abnormal chest sounds Other symptoms involving respiratory system and chest Bacteremia Nonspecific abnormal findings on radiological and other examination of other intrathoracic organs Nonspecific abnormal findings on radiological and other examination of abdominal area, including retroperitoneum Nonspecific abnormal unspecified cardiovascular function study Nonspecific abnormal electrocardiogram (ECG) (EKG) Other nonspecific abnormal cardiovascular system function study Nonspecific abnormal findings on chromosomal analysis Nonspecific low blood pressure reading Asphyxia Hypoxemia Respiratory arrest Closed fracture of rib(s), unspecified Closed fracture of one rib Closed fracture of two ribs Closed fracture of three ribs Closed fracture of multiple ribs, unspecified Closed fracture of sternum Flail chest Subarachnoid hemorrhage following injury, without mention of open intracranial wound, unspecified state of consciousness Subarachnoid hemorrhage following injury, without mention of open intracranial wound, no loss of consciousness Subdural hemorrhage following injury, without mention of open intracranial 78550 78551 78552 78559 7859 78600 78603 78604 78605 78606 78607 78609 7863 78650 78651 78652 78659 7867 7869 7907 7932 7936 79430 79431 79439 7952 7963 79901 79902 7991 80700 80701 80702 80703 80709 8072 8074 85200 85201 85222 31 wound, with brief [less than one hour] loss of consciousness Subdural hemorrhage following injury, without mention of open intracranial wound, loss of consciousness of unspecified duration Other and unspecified intracranial hemorrhage following injury, without mention of open intracranial wound, unspecified state of consciousness Traumatic pneumothorax without mention of open wound into thorax Traumatic hemothorax without mention of open wound into thorax Unspecified injury to heart without mention of open wound into thorax Heart contusion without mention of open wound into thorax Contusion of chest wall Traumatic shock Other injury of chest wall Poisoning by antineoplastic antibiotics Poisoning by antineoplastic and immunosuppressive drugs Poisoning by anticoagulants Poisoning by opium (alkaloids), unspecified Poisoning by opiates and related narcotics, other Poisoning by benzodiazepine-based tranquilizers Poisoning by cardiotonic glycosides and drugs of similar action Poisoning by unspecified drug or medicinal substance Effects of radiation, unspecified Angioneurotic edema not elsewhere classified Other and unspecified adverse effect of drug, medicinal and biological substance Unspecified adverse effect of unspecified drug, medicinal and biological substance Unspecified adverse effect of other drug, medicinal and biological substance Sepsis Severe sepsis Mechanical complication of unspecified cardiac device, implant, and graft Mechanical complication due to cardiac pacemaker (electrode) Mechanical complication due to heart valve prosthesis Mechanical complication due to coronary bypass graft Mechanical complication due to automatic implantable cardiac defibrillator Mechanical complication of cardiac device, implant, and graft, other Mechanical complication of other vascular device, implant, and graft Infection and inflammatory reaction due to cardiac device, implant, and graft Infection and inflammatory reaction due to other vascular device, implant, and graft Infection and inflammatory reaction due to peritoneal dialysis catheter Other complications due to heart valve prosthesis Other complications due to other cardiac device, implant, and graft Other complications due to renal dialysis device, implant, and graft Other complications due to other vascular device, implant, and graft 85226 85300 8600 8602 86100 86101 9221 9584 95911 9607 9631 9642 96500 96509 9694 9721 9779 990 9951 9952 99520 99529 99591 99592 99600 99601 99602 99603 99604 99609 9961 99661 99662 99668 99671 99672 99673 99674 32 Complications of transplanted kidney Complications of transplanted heart Complications of transplanted lung Cardiac complications Respiratory complications Postoperative shock, not elsewhere classified Accidental puncture or laceration during procedure Antineoplastic and immunosuppressive drugs causing adverse effect in therapeutic use Personal history of malignant neoplasm of breast Personal history of venous thrombosis and embolism Personal history of transient ischemic attack [TIA], and cerebral infarction without residual deficits Personal history of other diseases of circulatory system Personal history of surgery to heart and great vessels, presenting hazards to health Family history of other cardiovascular diseases Kidney replaced by transplant Heart replaced by transplant Heart valve replaced by transplant Lung replaced by transplant Organ or tissue replaced by other means, Heart assist device Heart valve replaced by other means Blood vessel replaced by other means Unspecified cardiac device in situ Cardiac pacemaker in situ Automatic implantable cardiac defibrillator in situ Other specified cardiac device in situ Postprocedural aortocoronary bypass status Postprocedural percutaneous transluminal coronary angioplasty status Other cardiorespiratory problems Fitting and adjustment of cardiac pacemaker Fitting and adjustment of automatic implantable cardiac defibrillator Encounter for antineoplastic chemotherapy Encounter for antineoplastic immunotherapy Aftercare following organ transplant Encounter for long-term (current) use of other medications Encounter for therapeutic drug monitoring Chemotherapy follow-up examination Follow-up examination following completed treatment with high-risk medications, not elsewhere classified Observation for suspected cardiovascular disease 99681 99683 99684 9971 9973 9980 9982 E9331 V103 V1251 V1254 V1259 V151 V1749 V420 V421 V422 V426 V4321 V433 V434 V4500 V4501 V4502 V4509 V4581 V4582 V472 V5331 V5332 V5811 V5812 V5844 V5869 V5883 V672 V6751 V717 33 ICD-9 Codes for Excluding Electrocardiograms Electrocardiograms were excluded from the analysis if the associated primary, secondary, tertiary, or quaternary diagnosis involved: (i) proximal fractures; (ii) pulmonary and chest conditions, including anything potentially resulting in chest pain (e.g., chest wall contusion); (iii) esophageal conditions (e.g., esophagitis and esophageal spasm), except those that are painless, mild, and chronic (e.g., esophageal stricture, Barrett’s esophagus, and reflux); (iv) cardiac conditions, including shortness of breath, edema, congestive heart failure and anatomic anomalies; (v) end stage renal disease and dialysis, along with all electrolyte abnormalities; (vi) infections, including sepsis, but not urinary tract infections or pneumonia; (vii) anemia and bleeding conditions, except microscopic hematuria; (viii) abdominal conditions (including abdominal pain), but not benign tumor of the colon; (ix) psychiatric conditions; (x) acute central nervous system conditions (e.g., cerebrovascular accident, delirium) and seizure or epilepsy conditions, but not chronic conditions (e.g., dementia), head ache, or migraine; (xi) drug toxicity and poisoning; (xii) transplants; (xiii) malignant hypertension; (xiv) cancers; (xv) conditions involving arterial and pulmonary emboli, but not peripheral deep vein thrombosis; (xvi) falls; (xvii) autoimmune conditions; or (xviii) pain in the anterior and posterior thorax and shoulder areas (eg. back pain), but not specific shoulder conditions such as “capsular adhesion of shoulder” and “osteoarthrosis of shoulder.” Label Salmonella septicemia Human immunodeficiency virus [HIV] Unspecified food poisoning Sarcoidosis Malignant neoplasm of uterus, part unspecified Malignant neoplasm of prostate Malignant neoplasm of thyroid gland Nutritional marasmus Other severe protein-calorie malnutrition Depressive disorder, not elsewhere classified Disseminated diseases due to other mycobacteria Multiple sclerosis Streptococcal septicemia Pneumococcal septicemia Septicemia due to anaerobes Other specified septicemia Unspecified septicemia Rheumatic fever without mention of heart involvement Gas gangrene Old myocardial infarction Subarachnoid hemorrhage Intracerebral hemorrhage Code 0031 042 0059 135 179 185 193 261 262 311 0312 340 0380 0382 0383 0388 0389 390 0400 412 430 431 34 Acute, but ill-defined, cerebrovascular disease Portal vein thrombosis Unspecified viral meningitis Bronchitis, not specified as acute or chronic Unspecified non-arthropod-borne viral disease of central nervous system Coal workers' pneumoconiosis Asbestosis Pulmonary congestion and hypostasis Postinflammatory pulmonary fibrosis Appendicitis, unqualified Herpetic meningoencephalitis Acute and subacute necrosis of liver Unspecified renal failure Respiratory distress syndrome in newborn Toxic effect of carbon monoxide Effects of radiation, unspecified Candidiasis of lung Disseminated candidiasis Aspergillosis Malignant neoplasm of lower lip, vermilion border Malignant neoplasm of base of tongue Malignant neoplasm of anterior two-thirds of tongue, part unspecified Malignant neoplasm of tongue, unspecified site Malignant neoplasm of parotid gland Malignant neoplasm of floor of mouth, part unspecified Malignant neoplasm of mouth, unspecified site Malignant neoplasm of tonsil Malignant neoplasm of oropharynx, unspecified site Malignant neoplasm of nasopharynx, unspecified site Malignant neoplasm of thoracic esophagus Malignant neoplasm of upper third of esophagus Malignant neoplasm of middle third of esophagus Malignant neoplasm of lower third of esophagus Malignant neoplasm of other specified part of esophagus Malignant neoplasm of esophagus, unspecified site Malignant neoplasm of cardia Malignant neoplasm of pylorus Malignant neoplasm of pyloric antrum Malignant neoplasm of fundus of stomach Malignant neoplasm of body of stomach Malignant neoplasm of lesser curvature of stomach, unspecified Malignant neoplasm of other specified sites of stomach Malignant neoplasm of stomach, unspecified site 436 452 0479 490 0499 500 501 514 515 541 0543 570 586 769 986 990 1124 1125 1173 1401 1410 1414 1419 1420 1449 1459 1460 1469 1479 1501 1503 1504 1505 1508 1509 1510 1511 1512 1513 1514 1515 1518 1519 35 Malignant neoplasm of duodenum Malignant neoplasm of ileum Malignant neoplasm of small intestine, unspecified site Malignant neoplasm of hepatic flexure Malignant neoplasm of transverse colon Malignant neoplasm of descending colon Malignant neoplasm of sigmoid colon Malignant neoplasm of cecum Malignant neoplasm of appendix Malignant neoplasm of ascending colon Malignant neoplasm of splenic flexure Malignant neoplasm of other specified sites of large intestine Malignant neoplasm of colon, unspecified site Malignant neoplasm of rectosigmoid junction Malignant neoplasm of rectum Malignant neoplasm of anal canal Malignant neoplasm of anus, unspecified site Malignant neoplasm of other sites of rectum, rectosigmoid junction, and anus Malignant neoplasm of liver, primary Malignant neoplasm of intrahepatic bile ducts Malignant neoplasm of liver, not specified as primary or secondary Malignant neoplasm of gallbladder Malignant neoplasm of extrahepatic bile ducts Malignant neoplasm of ampulla of Vater Malignant neoplasm of biliary tract, part unspecified site Malignant neoplasm of head of pancreas Malignant neoplasm of body of pancreas Malignant neoplasm of tail of pancreas Malignant neoplasm of other specified sites of pancreas Malignant neoplasm of pancreas, part unspecified Malignant neoplasm of retroperitoneum Malignant neoplasm of specified parts of peritoneum Malignant neoplasm of peritoneum, unspecified Malignant neoplasm of intestinal tract, part unspecified Malignant neoplasm of nasal cavities Malignant neoplasm of maxillary sinus Malignant neoplasm of glottis Malignant neoplasm of supraglottis Malignant neoplasm of other specified sites of larynx Malignant neoplasm of larynx, unspecified site Malignant neoplasm of trachea Malignant neoplasm of main bronchus Malignant neoplasm of upper lobe, bronchus, or lung 1520 1522 1529 1530 1531 1532 1533 1534 1535 1536 1537 1538 1539 1540 1541 1542 1543 1548 1550 1551 1552 1560 1561 1562 1569 1570 1571 1572 1578 1579 1580 1588 1589 1590 1600 1602 1610 1611 1618 1619 1620 1622 1623 36 Malignant neoplasm of middle lobe, bronchus, or lung Malignant neoplasm of lower lobe, bronchus, or lung Malignant neoplasm of other parts of bronchus or lung Malignant neoplasm of bronchus and lung, unspecified site Malignant neoplasm of other specified sites of pleura Malignant neoplasm of pleura, unspecified site Malignant neoplasm of thymus Malignant neoplasm of heart Malignant neoplasm of mediastinum, part unspecified Malignant neoplasm of bone and articular cartilage, site unspecified Malignant neoplasm of connective and other soft tissue of head, face, and neck Malignant neoplasm of connective and other soft tissue of upper limb, including shoulder Malignant neoplasm of connective and other soft tissue of lower limb, including hip Malignant neoplasm of connective and other soft tissue of thorax Malignant neoplasm of connective and other soft tissue of abdomen Malignant neoplasm of connective and other soft tissue, site unspecified Malignant melanoma of skin of ear and external auditory canal Malignant melanoma of skin of other and unspecified parts of face Malignant melanoma of skin of scalp and neck Malignant melanoma of skin of trunk, except scrotum Malignant melanoma of skin of upper limb, including shoulder Malignant melanoma of skin of lower limb, including hip Malignant melanoma of other specified sites of skin Melanoma of skin, site unspecified Other malignant neoplasm of skin of lip Other malignant neoplasm of skin of eyelid, including canthus Other malignant neoplasm of skin of ear and external auditory canal Other malignant neoplasm of skin of other and unspecified parts of face Other malignant neoplasm of scalp and skin of neck Other malignant neoplasm of skin of trunk, except scrotum Other malignant neoplasm of skin of upper limb, including shoulder Other malignant neoplasm of skin of lower limb, including hip Other malignant neoplasm of other specified sites of skin Other malignant neoplasm of skin, site unspecified Malignant neoplasm of nipple and areola of female breast Malignant neoplasm of central portion of female breast Malignant neoplasm of upper-inner quadrant of female breast Malignant neoplasm of lower-inner quadrant of female breast Malignant neoplasm of upper-outer quadrant of female breast Malignant neoplasm of lower-outer quadrant of female breast Malignant neoplasm of other specified sites of female breast 1624 1625 1628 1629 1638 1639 1640 1641 1649 1709 1710 1712 1713 1714 1715 1719 1722 1723 1724 1725 1726 1727 1728 1729 1730 1731 1732 1733 1734 1735 1736 1737 1738 1739 1740 1741 1742 1743 1744 1745 1748 37 Malignant neoplasm of breast (female), unspecified site Malignant neoplasm of other and unspecified sites of male breast Malignant neoplasm of endocervix Malignant neoplasm of cervix uteri, unspecified site Malignant neoplasm of corpus uteri, except isthmus Malignant neoplasm of ovary Malignant neoplasm of fallopian tube Malignant neoplasm of vagina Malignant neoplasm of vulva, unspecified site Malignant neoplasm of other and unspecified testis Malignant neoplasm of penis, part unspecified Malignant neoplasm of trigone of urinary bladder Malignant neoplasm of dome of urinary bladder Malignant neoplasm of lateral wall of urinary bladder Malignant neoplasm of anterior wall of urinary bladder Malignant neoplasm of posterior wall of urinary bladder Malignant neoplasm of bladder neck Malignant neoplasm of ureteric orifice Malignant neoplasm of other specified sites of bladder Malignant neoplasm of bladder, part unspecified Malignant neoplasm of kidney, except pelvis Malignant neoplasm of renal pelvis Malignant neoplasm of ureter Malignant neoplasm of urethra Malignant neoplasm of urinary organ, site unspecified Malignant neoplasm of choroid Malignant neoplasm of cerebrum, except lobes and ventricles Malignant neoplasm of frontal lobe of brain Malignant neoplasm of temporal lobe of brain Malignant neoplasm of parietal lobe of brain Malignant neoplasm of occipital lobe of brain Malignant neoplasm of other parts of brain Malignant neoplasm of brain, unspecified site Malignant neoplasm of cerebral meninges Malignant neoplasm of adrenal gland Malignant neoplasm of head, face, and neck Malignant neoplasm of thorax Malignant neoplasm of abdomen Secondary and unspecified malignant neoplasm of lymph nodes of head, face, and neck Secondary and unspecified malignant neoplasm of intrathoracic lymph nodes Secondary and unspecified malignant neoplasm of intra-abdominal lymph nodes Secondary and unspecified malignant neoplasm of lymph nodes of axilla and 1749 1759 1800 1809 1820 1830 1832 1840 1844 1869 1874 1880 1881 1882 1883 1884 1885 1886 1888 1889 1890 1891 1892 1893 1899 1906 1910 1911 1912 1913 1914 1918 1919 1921 1940 1950 1951 1952 1960 1961 1962 1963 38 upper limb Secondary and unspecified malignant neoplasm of lymph nodes of inguinal region and lower limb Secondary malignant neoplasm of lung Secondary malignant neoplasm of mediastinum Secondary malignant neoplasm of pleura Secondary malignant neoplasm of small intestine including duodenum Secondary malignant neoplasm of large intestine and rectum Secondary malignant neoplasm of retroperitoneum and peritoneum Secondary malignant neoplasm of liver Secondary malignant neoplasm of other digestive organs and spleen Secondary malignant neoplasm of kidney Secondary malignant neoplasm of other urinary organs Secondary malignant neoplasm of skin Secondary malignant neoplasm of brain and spinal cord Secondary malignant neoplasm of other parts of nervous system Secondary malignant neoplasm of bone and bone marrow Secondary malignant neoplasm of adrenal gland Disseminated malignant neoplasm Other malignant neoplasm of unspecified site Benign neoplasm of bronchus and lung Benign neoplasm of heart Benign neoplasm of brain Benign neoplasm of cerebral meninges Benign neoplasm of spinal meninges Carcinoma in situ of esophagus Carcinoma in situ of stomach Carcinoma in situ of colon Carcinoma in situ of rectum Carcinoma in situ of larynx Carcinoma in situ of bronchus and lung Carcinoma in situ of breast Carcinoma in situ of cervix uteri Carcinoma in situ of other and unspecified parts of uterus Carcinoma in situ, other and unspecified female genital organs Carcinoma in situ of prostate Carcinoma in situ of bladder Carcinoma in situ of other specified sites Neoplasm of uncertain behavior of major salivary glands Neoplasm of uncertain behavior of lip, oral cavity, and pharynx Neoplasm of uncertain behavior of stomach, intestines, and rectum Neoplasm of uncertain behavior of liver and biliary passages Neoplasm of uncertain behavior of other and unspecified digestive organs 1965 1970 1971 1972 1974 1975 1976 1977 1978 1980 1981 1982 1983 1984 1985 1987 1990 1991 2123 2127 2250 2252 2254 2301 2302 2303 2304 2310 2312 2330 2331 2332 2333 2334 2337 2348 2350 2351 2352 2353 2355 39 Neoplasm of uncertain behavior of larynx Neoplasm of uncertain behavior of trachea, bronchus, and lung Neoplasm of uncertain behavior of ovary Neoplasm of uncertain behavior of prostate Neoplasm of uncertain behavior of bladder Neoplasm of uncertain behavior of pituitary gland and craniopharyngeal duct Neoplasm of uncertain behavior of other and unspecified endocrine glands Neoplasm of uncertain behavior of brain and spinal cord Neoplasm of uncertain behavior of bone and articular cartilage Neoplasm of uncertain behavior of connective and other soft tissue Neoplasm of uncertain behavior of skin Neoplasm of uncertain behavior of breast Neoplasm of uncertain behavior of polycythemia vera Neoplasm of uncertain behavior of other specified sites Neoplasm of uncertain behavior, site unspecified Neoplasm of unspecified nature of digestive system Neoplasm of unspecified nature of respiratory system Neoplasms of unspecified nature of bone, soft tissue, and skin Neoplasm of unspecified nature of breast Neoplasm of unspecified nature of bladder Neoplasm of unspecified nature of other genitourinary organs Neoplasm of unspecified nature of brain Neoplasm of unspecified nature of endocrine glands and other parts of nervous system Neoplasm of unspecified nature of other specified sites Neoplasm of unspecified nature, site unspecified Acute thyroiditis Unspecified thyroiditis Hypoglycemic coma Other specified hypoglycemia Hypoglycemia, unspecified Diabetes insipidus Carcinoid syndrome Unspecified protein-calorie malnutrition Other and unspecified manifestations of thiamine deficiency Monoclonal paraproteinemia Disorders of magnesium metabolism Disorders of phosphorus metabolism Hyperosmolality and/or hypernatremia Hyposmolality and/or hyponatremia Acidosis Alkalosis Mixed acid-base balance disorder 2356 2357 2362 2365 2367 2370 2374 2375 2380 2381 2382 2383 2384 2388 2389 2390 2391 2392 2393 2394 2395 2396 2397 2398 2399 2450 2459 2510 2511 2512 2535 2592 2639 2651 2731 2752 2753 2760 2761 2762 2763 2764 40 Fluid overload Hyperpotassemia Hypopotassemia Electrolyte and fluid disorders not elsewhere classified Amyloidosis Unspecified disorder of metabolism Iron deficiency anemia secondary to blood loss (chronic) Iron deficiency anemia secondary to inadequate dietary iron intake Other specified iron deficiency anemias Unspecified iron deficiency anemia Pernicious anemia Other vitamin B12 deficiency anemia Folate-deficiency anemia Other specified megaloblastic anemias not elsewhere classified Anemia associated with other specified nutritional deficiency Unspecified deficiency anemia Autoimmune hemolytic anemias Acquired hemolytic anemia, unspecified Pancytopenia Other specified aplastic anemias Unspecified aplastic anemia Sideroblastic anemia Acute posthemorrhagic anemia Chemotherapy induced anemia Other specified anemias Unspecified anemia Hemorrhagic disorder due to intrinsic circulating anticoagulants Defibrination syndrome Unspecified hemorrhagic conditions Polycythemia, secondary Senile dementia with delirium Unspecified senile psychotic condition Alcohol withdrawal delirium Drug withdrawal Unspecified drug-induced mental disorder Delirium due to conditions classified elsewhere Subacute delirium Unspecified transient mental disorder in conditions classified elsewhere Other persistent mental disorders due to conditions classified elsewhere Unspecified persistent mental disorders due to conditions classified elsewhere Bipolar I disorder, most recent episode (or current) unspecified Delusional disorder Unspecified paranoid state 2766 2767 2768 2769 2773 2779 2800 2801 2808 2809 2810 2811 2812 2813 2818 2819 2830 2839 2841 2848 2849 2850 2851 2853 2858 2859 2865 2866 2879 2890 2903 2909 2910 2920 2929 2930 2931 2939 2948 2949 2967 2971 2979 41 Reactive confusion Other and unspecified reactive psychosis Unspecified psychosis Obsessive-compulsive disorders Dysthymic disorder Unspecified nonpsychotic mental disorder Respiratory malfunction arising from mental factors Cardiovascular malfunction arising from mental factors Anorexia nervosa Predominant disturbance of emotions Unspecified acute reaction to stress Adjustment disorder with depressed mood Prolonged depressive reaction as adjustment reaction Adjustment disorder with mixed disturbance of emotions and conduct Unspecified adjustment reaction Personality change due to conditions classified elsewhere Postconcussion syndrome Unspecified nonpsychotic mental disorder following organic brain damage Meningitis due to unspecified bacterium Unspecified meningitis Unspecified causes of encephalitis, myelitis, and encephalomyelitis Intracranial abscess Communicating hydrocephalus Obstructive hydrocephalus Idiopathic normal pressure hydrocephalus [INPH] Paralysis agitans Secondary Parkinsonism Neoplasm related pain (acute) (chronic) Unspecified infantile cerebral palsy Unspecified paralysis Anoxic brain damage Benign intracranial hypertension Cerebral edema Atypical face pain Unspecified inflammatory and toxic neuropathy Toxic myopathy Unspecified visual disturbance Unspecified visual loss Unspecified staphylococcal septicemia Methicillin susceptible Staphylococcus aureus septicemia Methicillin resistant Staphylococcus aureus septicemia Other staphylococcal septicemia Septicemia due to unspecified gram-negative organism 2982 2988 2989 3003 3004 3009 3061 3062 3071 3080 3089 3090 3091 3094 3099 3101 3102 3109 3209 3229 3239 3240 3313 3314 3315 3320 3321 3383 3439 3449 3481 3482 3485 3502 3579 3594 3689 3699 03810 03811 03812 03819 03840 42 Septicemia due to hemophilus influenzae (H. influenzae) Septicemia due to Escherichia coli (E. coli) Septicemia due to pseudomonas Septicemia due to serratia Other septicemia due to gram-negative organism Acute rheumatic pericarditis Acute rheumatic endocarditis Other acute rheumatic heart disease Unspecified acute rheumatic heart disease Mitral stenosis Rheumatic mitral insufficiency Mitral stenosis with insufficiency Other and unspecified mitral valve diseases Rheumatic aortic stenosis Rheumatic aortic insufficiency Rheumatic aortic stenosis with insufficiency Other and unspecified rheumatic aortic diseases Mitral valve stenosis and aortic valve stenosis Mitral valve stenosis and aortic valve insufficiency Mitral valve insufficiency and aortic valve stenosis Mitral valve insufficiency and aortic valve insufficiency Multiple involvement of mitral and aortic valves Unspecified mitral and aortic valve diseases Diseases of tricuspid valve Rheumatic diseases of pulmonary valve Essential hypertension, malignant Postmyocardial infarction syndrome Intermediate coronary syndrome Angina decubitus Prinzmetal angina Other and unspecified angina pectoris Chronic total occlusion of coronary artery Coronary atherosclerosis due to lipid rich plaque Other specified forms of chronic ischemic heart disease Unspecified chronic ischemic heart disease Acute cor pulmonale Primary pulmonary hypertension Chronic pulmonary embolism Other chronic pulmonary heart diseases Unspecified chronic pulmonary heart disease Arteriovenous fistula of pulmonary vessels Aneurysm of pulmonary artery Other specified disease of pulmonary circulation 03841 03842 03843 03844 03849 3910 3911 3918 3919 3940 3941 3942 3949 3950 3951 3952 3959 3960 3961 3962 3963 3968 3969 3970 3971 4010 4110 4111 4130 4131 4139 4142 4143 4148 4149 4150 4160 4162 4168 4169 4170 4171 4178 43 Unspecified disease of pulmonary circulation Acute pericarditis in diseases classified elsewhere Acute and subacute bacterial endocarditis Acute and subacute infective endocarditis in diseases classified elsewhere Unspecified acute endocarditis Hemopericardium Adhesive pericarditis Constrictive pericarditis Cardiac tamponade Other specified diseases of pericardium Unspecified disease of pericardium Mitral valve disorders Aortic valve disorders Tricuspid valve disorders, specified as nonrheumatic Pulmonary valve disorders Endomyocardial fibrosis Hypertrophic obstructive cardiomyopathy Obscure cardiomyopathy of Africa Endocardial fibroelastosis Other primary cardiomyopathies Alcoholic cardiomyopathy Nutritional and metabolic cardiomyopathy Cardiomyopathy in other diseases classified elsewhere Unspecified secondary cardiomyopathy Atrioventricular block, complete Left bundle branch hemiblock Other left bundle branch block Right bundle branch block Other heart block Anomalous atrioventricular excitation Unspecified conduction disorder Paroxysmal supraventricular tachycardia Paroxysmal ventricular tachycardia Unspecified paroxysmal tachycardia Cardiac arrest Unspecified cardiac dysrhythmia Congestive heart failure, unspecified Left heart failure Unspecified heart failure Unspecified myocarditis Myocardial degeneration Unspecified cardiovascular disease Cardiomegaly 4179 4200 4210 4211 4219 4230 4231 4232 4233 4238 4239 4240 4241 4242 4243 4250 4251 4252 4253 4254 4255 4257 4258 4259 4260 4262 4263 4264 4266 4267 4269 4270 4271 4272 4275 4279 4280 4281 4289 4290 4291 4292 4293 44 Functional disturbances following cardiac surgery Rupture of chordae tendineae Rupture of papillary muscle Unspecified heart disease Nontraumatic extradural hemorrhage Subdural hemorrhage Unspecified intracranial hemorrhage Basilar artery syndrome Vertebral artery syndrome Subclavian steal syndrome Vertebrobasilar artery syndrome Other specified transient cerebral ischemias Unspecified transient cerebral ischemia Cerebral atherosclerosis Other generalized ischemic cerebrovascular disease Hypertensive encephalopathy Cerebral aneurysm, nonruptured Transient global amnesia Unspecified cerebrovascular disease Atherosclerosis of aorta Atherosclerosis of renal artery Chronic total occlusion of artery of the extremities Atherosclerosis of other specified arteries Generalized and unspecified atherosclerosis Thoracic aneurysm, ruptured Thoracic aneurysm without mention of rupture Abdominal aneurysm, ruptured Abdominal aneurysm without mention of rupture Aortic aneurysm of unspecified site, ruptured Thoracoabdominal aneurysm, ruptured Thoracoabdominal aneurysm without mention of rupture Aortic aneurysm of unspecified site without mention of rupture Aneurysm of artery of upper extremity Aneurysm of renal artery Aneurysm of iliac artery Aneurysm of artery of lower extremity Other aneurysm of unspecified site Thromboangiitis obliterans (Buerger's disease) Embolism and thrombosis of abdominal aorta Embolism and thrombosis of thoracic aorta Embolism and thrombosis of unspecified artery Polyarteritis nodosa Wegener's granulomatosis 4294 4295 4296 4299 4320 4321 4329 4350 4351 4352 4353 4358 4359 4370 4371 4372 4373 4377 4379 4400 4401 4404 4408 4409 4411 4412 4413 4414 4415 4416 4417 4419 4420 4421 4422 4423 4429 4431 4440 4441 4449 4460 4464 45 Giant cell arteritis Takayasu's disease Stricture of artery Rupture of artery Celiac artery compression syndrome Unspecified arteritis Other specified disorders of arteries and arterioles Unspecified disorders of arteries and arterioles Embolism and thrombosis of vena cava Emb/throm superficial lower ext Venous embolism and thrombosis of other specified veins Embolism and thrombosis of unspecified site Esophageal varices with bleeding Other noninfectious lymphedema Orthostatic hypotension Chronic hypotension Other specified hypotension Unspecified hypotension Unspecified hemorrhage Unspecified circulatory system disorder Acute upper respiratory infections of other multiple sites Acute upper respiratory infections of unspecified site Acute bronchitis Other and unspecified diseases of upper respiratory tract Emphysematous bleb Other emphysema Bronchiectasis with acute exacerbation Acute pulmonary edema due to fumes and vapors Other acute and subacute respiratory conditions due to fumes and vapors Acute pulmonary manifestations due to radiation Empyema without mention of fistula Pleurisy without mention of effusion or current tuberculosis Pleurisy with effusion, with mention of bacterial cause other than tuberculosis Other specified forms of pleural effusion, except tuberculous Unspecified pleural effusion Spontaneous tension pneumothorax Iatrogenic pneumothorax Other spontaneous pneumothorax Abscess of lung Idiopathic fibrosing alveolitis Other specified alveolar and parietoalveolar pneumonopathies Acute chest syndrome Lung involvement in other diseases classified elsewhere 4465 4467 4471 4472 4474 4476 4478 4479 4532 4536 4538 4539 4560 4571 4580 4581 4588 4589 4590 4599 4658 4659 4660 4789 4920 4928 4941 5061 5063 5080 5109 5110 5111 5118 5119 5120 5121 5128 5130 5163 5168 5173 5178 46 Pulmonary collapse Compensatory emphysema Pulmonary eosinophilia Unspecified acute edema of lung Pulmonary insufficiency following trauma and surgery Other diseases of trachea and bronchus, not elsewhere classified Other diseases of respiratory system, not elsewhere classified Unspecified disease of respiratory system Inflammatory conditions of jaw Achalasia and cardiospasm Stricture and stenosis of esophagus Perforation of esophagus Gastroesophageal laceration-hemorrhage syndrome Unspecified disorder of esophagus Dyspepsia and other specified disorders of function of stomach Acute appendicitis with generalized peritonitis Acute appendicitis with peritoneal abscess Acute appendicitis without mention of peritonitis Hernia of other specified site, with obstruction Acute vascular insufficiency of intestine Volvulus Unspecified intestinal obstruction Unspecified peritonitis Hemorrhage of rectum and anus Abscess of liver Hepatic coma Portal hypertension Acute cholecystitis Perforation of gallbladder Cholangitis Acute pancreatitis Chronic pancreatitis Hematemesis Blood in stool Hemorrhage of gastrointestinal tract, unspecified Other and unspecified postsurgical nonabsorption Acute renal failure with lesion of tubular necrosis Acute renal failure with lesion of renal cortical necrosis Acute renal failure with other specified pathological lesion in kidney End stage renal disease Hemorrhage into bladder wall Excessive or frequent menstruation Other disorder of menstruation and other abnormal bleeding from female genital 5180 5182 5183 5184 5185 5191 5198 5199 5264 5300 5303 5304 5307 5309 5368 5400 5401 5409 5528 5570 5602 5609 5679 5693 5720 5722 5723 5750 5754 5761 5770 5771 5780 5781 5789 5793 5845 5846 5848 5856 5967 6262 6268 47 tract Postmenopausal bleeding West Nile fever with encephalitis Lupus erythematosus Circumscribed scleroderma Chronic hepatitis C with hepatic coma Systemic lupus erythematosus Unspecified diffuse connective tissue disease Pain in thoracic spine Lumbago Thoracic or lumbosacral neuritis or radiculitis, unspecified Unspecified backache Other symptoms referable to back Other affections of shoulder region, not elsewhere classified Tietze's disease Nonallopathic lesion of thoracic region, not elsewhere classified Bulbus cordis anomalies and anomalies of cardiac septal closure, common truncus Tetralogy of Fallot Bulbus cordis anomalies and anomalies of cardiac septal closure, common ventricle Ventricular septal defect Ostium secundum type atrial septal defect Unspecified congenital defect of septal closure Congenital tricuspid atresia and stenosis Ebstein's anomaly Congenital stenosis of aortic valve Congenital insufficiency of aortic valve Congenital mitral stenosis Congenital mitral insufficiency Hypoplastic left heart syndrome Unspecified congenital anomaly of heart Patent ductus arteriosus Congenital anomalies of pulmonary artery Congenital tracheoesophageal fistula, esophageal atresia and stenosis Down's syndrome Hallucinations Syncope and collapse Dizziness and giddiness Transient paralysis of limb Edema Cyanosis Anorexia 6271 06641 6954 7010 07044 7100 7109 7241 7242 7244 7245 7248 7262 7336 7392 7450 7452 7453 7454 7455 7459 7461 7462 7463 7464 7465 7466 7467 7469 7470 7473 7503 7580 7801 7802 7804 7814 7823 7825 7830 48 Polydipsia Adult failure to thrive Other speech disturbance Unspecified tachycardia Palpitations Undiagnosed cardiac murmurs Other abnormal heart sounds Gangrene Other symptoms involving cardiovascular system Stridor Cough Hemoptysis Abnormal chest sounds Other symptoms involving respiratory system and chest Heartburn Dysphagia Nonspecific elevation of levels of transaminase or lactic acid dehydrogenase (LDH) Other nonspecific abnormal serum enzyme levels Other abnormal blood chemistry Bacteremia Nonspecific abnormal findings on radiological and other examination of lung field Nonspecific abnormal findings on radiological and other examination of other intrathoracic organs Nonspecific abnormal results of pulmonary system function study Nonspecific abnormal toxicological findings Nonspecific low blood pressure reading Respiratory arrest Cachexia Closed fracture of dorsal (thoracic) vertebra without mention of spinal cord injury Closed fracture of lumbar spine with spinal cord injury Closed fracture of sternum Flail chest Closed fracture of acetabulum Closed fracture of pubis Unspecified closed fracture of pelvis Ill-defined closed fractures of upper limb Closed fracture of unspecified part of neck of femur Open fracture of unspecified part of neck of femur Sprain and strain of other specified sites of shoulder and upper arm Sprain and strain of unspecified site of shoulder and upper arm Thoracic sprain and strain 7835 7837 7845 7850 7851 7852 7853 7854 7859 7861 7862 7863 7867 7869 7871 7872 7904 7905 7906 7907 7931 7932 7942 7960 7963 7991 7994 8052 8064 8072 8074 8080 8082 8088 8180 8208 8209 8408 8409 8471 49 Sprain and strain of unspecified site of back Sprain and strain of ribs Concussion with loss of consciousness of unspecified duration Unspecified concussion Traumatic pneumothorax without mention of open wound into thorax Traumatic hemothorax without mention of open wound into thorax Traumatic pneumohemothorax without mention of open wound into thorax Injury to multiple and unspecified intrathoracic organs without mention of open wound into cavity Thoracic aorta injury Late effect of adverse effect of drug, medical or biological substance Contusion of breast Contusion of chest wall Contusion of abdominal wall Contusion of unspecified part of trunk Syphilitic endocarditis, aortic valve Foreign body in trachea Foreign body in main bronchus Foreign body in other specified parts of trachea, bronchus, and lung Unspecified site of spinal cord injury without spinal bone injury Traumatic shock Injury, other and unspecified, shoulder and upper arm Injury, other and unspecified, other specified sites, including multiple Poisoning by adrenal cortical steroids Poisoning by insulins and antidiabetic agents Poisoning by antiallergic and antiemetic drugs Poisoning by antineoplastic and immunosuppressive drugs Poisoning by anticoagulants Poisoning by salicylates Poisoning by aromatic analgesics, not elsewhere classified Poisoning by other specified analgesics and antipyretics Poisoning by unspecified analgesic and antipyretic Poisoning by hydantoin derivatives Poisoning by other and unspecified anticonvulsants Poisoning by barbiturates Poisoning by other sedatives and hypnotics Poisoning by unspecified sedative or hypnotic Poisoning by central nervous system muscle-tone depressants Poisoning by surface (topical) and infiltration anesthetics Poisoning by antidepressants Poisoning by phenothiazine-based tranquilizers Poisoning by butyrophenone-based tranquilizers Poisoning by other antipsychotics, neuroleptics, and major tranquilizers 8479 8483 8505 8509 8600 8602 8604 8628 9010 9095 9220 9221 9222 9229 09322 9340 9341 9348 9529 9584 9592 9598 9620 9623 9630 9631 9642 9651 9654 9658 9659 9661 9663 9670 9678 9679 9680 9685 9690 9691 9692 9693 50 Poisoning by benzodiazepine-based tranquilizers Poisoning by other tranquilizers Poisoning by psychodysleptics (hallucinogens) Poisoning by psychostimulants Poisoning by other specified psychotropic agents Poisoning by opiate antagonists Poisoning by other specified central nervous system stimulants Poisoning by parasympathomimetics (cholinergics) Poisoning by parasympatholytics (anticholinergics and antimuscarinics) and spasmolytics Poisoning by sympathomimetics (adrenergics) Poisoning by sympatholytics (antiadrenergics) Poisoning by cardiac rhythm regulators Poisoning by cardiotonic glycosides and drugs of similar action Poisoning by antilipemic and antiarteriosclerotic drugs Poisoning by coronary vasodilators Poisoning by other antihypertensive agents Poisoning by other and unspecified agents primarily affecting the cardiovascular system Poisoning by other diuretics Poisoning by electrolytic, caloric, and water-balance agents Poisoning by skeletal muscle relaxants Poisoning by antitussives Poisoning by other specified drugs and medicinal substances Poisoning by unspecified drug or medicinal substance Toxic effect of ethyl alcohol Toxic effect of isopropyl alcohol Toxic effect of unspecified alcohol Toxic effect of other nonpetroleum-based solvents Toxic effect of caustic, unspecified Toxic effect of other specified metals Toxic effect of other specified gases, fumes, or vapors Toxic effect of unspecified gas, fume, or vapor Toxic effect of other pesticides, not elsewhere classified Toxic effect of venom Toxic effect of unspecified substance, chiefly nonmedicinal as to source Effects of hypothermia Heat stroke and sunstroke Heat syncope Heat exhaustion, anhydrotic Heat exhaustion, unspecified Other specified heat effects Unspecified effects of heat and light 9694 9695 9696 9697 9698 9701 9708 9710 9711 9712 9713 9720 9721 9722 9724 9726 9729 9744 9745 9752 9754 9778 9779 9800 9802 9809 9828 9839 9858 9878 9879 9894 9895 9899 9916 9920 9921 9923 9925 9928 9929 51 Other and unspecified effects of high altitude Effects of lightning Drowning and nonfatal submersion Exhaustion due to excessive exertion Electrocution and nonfatal effects of electric current Other anaphylactic shock not elsewhere classified Angioneurotic edema not elsewhere classified Other and unspecified adverse effect of drug, medicinal and biological substance Mechanical complication of other vascular device, implant, and graft Cardiac complications Respiratory complications Postoperative shock, not elsewhere classified Accidental puncture or laceration during procedure Other infusion and transfusion reaction Candidiasis of the esophagus Secondary malignant neoplasm of breast Secondary malignant neoplasm of genital organs Secondary malignant neoplasm of other specified sites Mantle cell lymphoma, unspecified site, extranodal and solid organ sites Large cell lymphoma, unspecified site, extranodal and solid organ sites Hodgkin's disease, unspecified type, unspecified site, extranodal and solid organ sites Nodular lymphoma, unspecified site, extranodal and solid organ sites Nodular lymphoma of lymph nodes of head, face, and neck Nodular lymphoma of intra-abdominal lymph nodes Nodular lymphoma of lymph nodes of multiple sites Mycosis fungoides, unspecified site, extranodal and solid organ sites Leukemic reticuloendotheliosis, unspecified site, extranodal and solid organ sites Other malignant lymphomas, unspecified site, extranodal and solid organ sites Other malignant lymphomas of lymph nodes of head, face, and neck Other malignant lymphomas of intrathoracic lymph nodes Other malignant lymphomas of intra-abdominal lymph nodes Other malignant lymphomas of lymph nodes of axilla and upper limb Other malignant lymphomas of lymph nodes of inguinal region and lower limb Other malignant lymphomas of lymph nodes of multiple sites Multiple myeloma, without mention of having achieved remission Multiple myeloma in remission Acute lymphoid leukemia, without mention of having achieved remission Chronic lymphoid leukemia, without mention of having achieved remission Chronic lymphoid leukemia in remission Unspecified lymphoid leukemia, without mention of having achieved remission Acute myeloid leukemia, without mention of having achieved remission Acute myeloid leukemia in remission 9932 9940 9941 9945 9948 9950 9951 9952 9961 9971 9973 9980 9982 9998 11284 19881 19882 19889 20040 20070 20190 20200 20201 20203 20208 20210 20240 20280 20281 20282 20283 20284 20285 20288 20300 20301 20400 20410 20411 20490 20500 20501 52 Chronic myeloid leukemia, without mention of having achieved remission Acute leukemia of unspecified cell type, without mention of having achieved remission Chronic leukemia of unspecified cell type, without mention of having achieved remission Unspecified leukemia, without mention of having achieved remission Malignant carcinoid tumor of the bronchus and lung Carcinoma in situ, vulva Neoplasm of uncertain behavior of kidney and ureter Low grade myelodysplastic syndrome lesions High grade myelodysplastic syndrome lesions Myelodysplastic syndrome, unspecified Myelofibrosis with myeloid metaplasia Neoplasms of unspecified nature, other specified sites Thyrotoxicosis of other specified origin without mention of thyrotoxic crisis or storm Thyrotoxicosis without mention of goiter or other cause, without mention of thyrotoxic crisis or storm Thyrotoxicosis without mention of goiter or other cause, with mention of thyrotoxic crisis Diabetes with ketoacidosis, type II or unspecified type, not stated as uncontrolled Diabetes with ketoacidosis, type I [juvenile type], not stated as uncontrolled Diabetes with ketoacidosis, type II or unspecified type, uncontrolled Diabetes with ketoacidosis, type I [juvenile type], uncontrolled Diabetes with hyperosmolarity, type II or unspecified type, not stated as uncontrolled Diabetes with hyperosmolarity, type II or unspecified type, uncontrolled Diabetes with other coma, type II or unspecified type, not stated as uncontrolled Diabetes with other coma, type II or unspecified type, uncontrolled Diabetes with other coma, type I [juvenile type], uncontrolled Glucocorticoid deficiency Unspecified disorder of calcium metabolism Hypocalcemia Hypercalcemia Other disorders of calcium metabolism Volume depletion, unspecified Dehydration Hypovolemia Fluid Overload NEC (Other Fluid Overload) Cystic fibrosis without mention of meconium ileus Cystic fibrosis with pulmonary manifestations Amyloidosis, unspecified Other amyloidosis Other thalassemia 20510 20800 20810 20890 20921 23332 23691 23872 23873 23875 23876 23989 24280 24290 24291 25010 25011 25012 25013 25020 25022 25030 25032 25033 25541 27540 27541 27542 27549 27650 27651 27652 27669 27700 27702 27730 27739 28249 53 Sickle-cell disease, unspecified Hb-SS disease with crisis Sickle-cell/Hb-C disease with crisis Other sickle-cell disease with crisis Other non-autoimmune hemolytic anemias Other pancytopenia Red cell aplasia (acquired) (adult) (with thymoma) Other specified aplastic anemias Anemia in chronic kidney disease Anemia in neoplastic disease Anemia of other chronic disease Neutropenia, unspecified Myelofibrosis Vascular dementia, with delirium Alcohol withdrawal Drug-induced psychotic disorder with hallucinations Drug-induced delirium Drug-induced mood disorder Other specified drug-induced mental disorder Mood disorder in conditions classified elsewhere Anxiety disorder in conditions classified elsewhere Simple schizophrenia, unspecified condition Catatonic schizophrenia, unspecified condition Paranoid schizophrenia, unspecified condition Paranoid schizophrenia, chronic condition Paranoid schizophrenia, chronic condition with acute exacerbation Schizophreniform disorder, unspecified Schizophrenic disorders, residual type, unspecified Schizoaffective disorder, unspecified Schizoaffective disorder, chronic Schizoaffective disorder, chronic with acute exacerbation Other specified types of schizophrenia, unspecified condition Other specified types of schizophrenia, chronic condition with acute exacerbation Unspecified schizophrenia, unspecified condition Unspecified schizophrenia, chronic condition Unspecified schizophrenia, chronic condition with acute exacerbation Bipolar I disorder, single manic episode, unspecified Major depressive disorder, single episode, unspecified Major depressive disorder, single episode, mild Major depressive disorder, single episode, moderate Major depressive disorder, single episode, severe, without mention of psychotic behavior Major depressive disorder, single episode, severe, specified as with psychotic 28260 28262 28264 28269 28319 28419 28481 28489 28521 28522 28529 28800 28983 29041 29181 29212 29281 29284 29289 29383 29384 29500 29520 29530 29532 29534 29540 29560 29570 29572 29574 29580 29584 29590 29592 29594 29600 29620 29621 29622 29623 29624 54 behavior Major depressive disorder, recurrent episode, unspecified Major depressive disorder, recurrent episode, mild Major depressive disorder, recurrent episode, moderate Major depressive disorder, recurrent episode, severe, without mention of psychotic behavior Major depressive disorder, recurrent episode, severe, specified as with psychotic behavior Bipolar I disorder, most recent episode (or current) manic, unspecified Bipolar I disorder, most recent episode (or current) manic, severe, without mention of psychotic behavior Bipolar I disorder, most recent episode (or current) manic, severe, specified as with psychotic behavior Bipolar I disorder, most recent episode (or current) depressed, unspecified Bipolar I disorder, most recent episode (or current) depressed, moderate Bipolar I disorder, most recent episode (or current) depressed, severe, without mention of psychotic behavior Bipolar I disorder, most recent episode (or current) depressed, severe, specified as with psychotic behavior Bipolar I disorder, most recent episode (or current) mixed, unspecified Bipolar I disorder, most recent episode (or current) mixed, moderate Bipolar I disorder, most recent episode (or current) mixed, severe, without mention of psychotic behavior Bipolar I disorder, most recent episode (or current) mixed, severe, specified as with psychotic behavior Bipolar disorder, unspecified Atypical depressive disorder Unspecified episodic mood disorder Other specified episodic mood disorder Autistic disorder, current or active state Anxiety state, unspecified Generalized anxiety disorder Other anxiety states Conversion disorder Borderline personality disorder Acute alcoholic intoxication, unspecified drunkenness Acute alcoholic intoxication, continuous drunkenness Acute alcoholic intoxication, episodic drunkenness Other and unspecified alcohol dependence, unspecified drunkenness Other and unspecified alcohol dependence, continuous drunkenness Opioid type dependence, unspecified abuse Opioid type dependence, continuous abuse Cocaine dependence, unspecified abuse Cocaine dependence, continuous abuse Combinations of opioid type drug with any other drug dependence, continuous 29630 29631 29632 29633 29634 29640 29643 29644 29650 29652 29653 29654 29660 29662 29663 29664 29680 29682 29690 29699 29900 30000 30002 30009 30011 30183 30300 30301 30302 30390 30391 30400 30401 30420 30421 30471 55 abuse Combinations of drug dependence excluding opioid type drug, unspecified abuse Unspecified drug dependence, unspecified abuse Nondependent alcohol abuse, unspecified drunkenness Nondependent alcohol abuse, continuous drunkenness Nondependent alcohol abuse, episodic drunkenness Nondependent cannabis abuse, unspecified Nondependent sedative, hypnotic or anxiolytic abuse, unspecified Nondependent opioid abuse, unspecified Nondependent cocaine abuse, unspecified Nondependent amphetamine or related acting sympathomimetic abuse, unspecified Other, mixed, or unspecified nondependent drug abuse, unspecified Eating disorder, unspecified Adjustment disorder with anxiety Adjustment disorder with mixed anxiety and depressed mood Posttraumatic stress disorder Impulse control disorder, unspecified Intermittent explosive disorder Attention deficit disorder of childhood without mention of hyperactivity Attention deficit disorder of childhood with hyperactivity Idiopathic sleep related nonobstructive alveolar hypoventilation Confusional arousals Subacute dyskinesia due to drugs Neuroleptic malignant syndrome Carotid sinus syndrome Acute pain due to trauma Acute post-thoracotomy pain Other acute pain Other specified paralytic syndrome Other forms of epilepsy and recurrent seizures, without mention of intractable epilepsy Migraine with aura, without mention of intractable migraine without mention of status migrainosus Migraine with aura, with intractable migraine, so stated, without mention of status migrainosus Migraine without aura, without mention of intractable migraine without mention of status migrainosus Migraine without aura, with intractable migraine, so stated, without mention of status migrainosus Variants of migraine, not elsewhere classified, without mention of intractable migraine without mention of status migrainosus Variants of migraine, not elsewhere classified, with intractable migraine, so stated, without mention of status migrainosus Chronic migraine without aura, with intractable migraine, so stated, without 30480 30490 30500 30501 30502 30520 30540 30550 30560 30570 30590 30750 30924 30928 30981 31230 31234 31400 31401 32724 32741 33385 33392 33701 33811 33812 33819 34489 34580 34600 34601 34610 34611 34620 34621 34671 56 mention of status migrainosus Other forms of migraine, without mention of intractable migraine without mention of status migrainosus Migraine, unspecified with intractable migraine, so stated, without mention of status migrainosus Narcolepsy, without cataplexy Encephalopathy, unspecified Metabolic encephalopathy Other encephalopathy Toxic encephalopathy Myasthenia gravis without (acute) exacerbation Myasthenia gravis with (acute) exacerbation Myotonic muscular dystrophy Unspecified retinal vascular occlusion Central artery occlusion of retina Arterial branch occlusion of retina Partial arterial occlusion of retina Transient arterial occlusion of retina Central vein occlusion of retina Sudden visual loss Transient visual loss Psychophysical visual disturbances Impairment level not further specified Unspecified rheumatic heart disease Rheumatic heart failure (congestive) Other and unspecified rheumatic heart diseases Malignant hypertensive heart disease without heart failure Malignant hypertensive heart disease with heart failure Benign hypertensive heart disease without heart failure Benign hypertensive heart disease with heart failure Unspecified hypertensive heart disease without heart failure Hypertensive heart disease, unspecified, with heart failure Hypertensive heart and chronic kidney disease, malignant, without heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, malignant, with heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, malignant, without heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, malignant, with heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, benign, without heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, benign, with heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, benign, without heart failure and 34680 34691 34700 34830 34831 34839 34982 35800 35801 35921 36230 36231 36232 36233 36234 36235 36811 36812 36816 36960 39890 39891 39899 40200 40201 40210 40211 40290 40291 40400 40401 40402 40403 40410 40411 40412 57 with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, benign, with heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, unspecified, without heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, unspecified, with heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, unspecified, without heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, unspecified, with heart failure and with chronic kidney disease stage V Secondary renovascular hypertension, malignant Other secondary hypertension, malignant Acute myocardial infarction of anterolateral wall, episode of care unspecified Acute myocardial infarction of anterolateral wall, initial episode of care Acute myocardial infarction of anterolateral wall, subsequent episode of care Acute myocardial infarction of other anterior wall, episode of care unspecified Acute myocardial infarction of other anterior wall, initial episode of care Acute myocardial infarction of other anterior wall, subsequent episode of care Acute myocardial infarction of inferolateral wall, episode of care unspecified Acute myocardial infarction of inferolateral wall, initial episode of care Acute myocardial infarction of inferolateral wall, subsequent episode of care Acute myocardial infarction of inferoposterior wall, episode of care unspecified Acute myocardial infarction of inferoposterior wall, initial episode of care Acute myocardial infarction of inferoposterior wall, subsequent episode of care Acute myocardial infarction of other inferior wall, episode of care unspecified Acute myocardial infarction of other inferior wall, initial episode of care Acute myocardial infarction of other inferior wall, subsequent episode of care Acute myocardial infarction of other lateral wall, episode of care unspecified Acute myocardial infarction of other lateral wall, initial episode of care Acute myocardial infarction of other lateral wall, subsequent episode of care Acute myocardial infarction, true posterior wall infarction, episode of care unspecified Acute myocardial infarction, true posterior wall infarction, initial episode of care Acute myocardial infarction, true posterior wall infarction, subsequent episode of care Acute myocardial infarction, subendocardial infarction, episode of care unspecified Acute myocardial infarction, subendocardial infarction, initial episode of care Acute myocardial infarction, subendocardial infarction, subsequent episode of care Acute myocardial infarction of other specified sites, episode of care unspecified Acute myocardial infarction of other specified sites, initial episode of care Acute myocardial infarction of other specified sites, subsequent episode of care Acute myocardial infarction, unspecified site, episode of care unspecified 40413 40490 40491 40492 40493 40501 40509 41000 41001 41002 41010 41011 41012 41020 41021 41022 41030 41031 41032 41040 41041 41042 41050 41051 41052 41060 41061 41062 41070 41071 41072 41080 41081 41082 41090 58 Acute myocardial infarction, unspecified site, initial episode of care Acute myocardial infarction, unspecified site, subsequent episode of care Acute coronary occlusion without myocardial infarction Other acute and subacute form of ischemic heart disease Coronary atherosclerosis of unspecified type of vessel, native or graft Coronary atherosclerosis of native coronary artery Coronary atherosclerosis of autologous vein bypass graft Coronary atherosclerosis of nonautologous biological bypass graft Coronary atherosclerosis of artery bypass graft Coronary atherosclerosis of unspecified type of bypass graft Coronary atherosclerosis, of native coronary artery of transplanted heart Coronary atherosclerosis, of bypass graft (artery) (vein) of transplanted heart Aneurysm of heart Aneurysm of coronary vessels Dissection of coronary artery Other aneurysm of heart Iatrogenic pulmonary embolism and infarction Septic pulmonary embolism Other pulmonary embolism and infarction Unspecified acute pericarditis Acute idiopathic pericarditis Other acute pericarditis Unspecified acute myocarditis Idiopathic myocarditis Endocarditis, valve unspecified, unspecified cause Endocarditis in diseases classified elsewhere Other endocarditis, valve unspecified Hypertrophic obstructive cardiomyopathy Other hypertrophic cardiomyopathy Unspecified atrioventricular block First degree atrioventricular block Mobitz (type) II atrioventricular block Other second degree atrioventricular block Unspecified bundle branch block Right bundle branch block and left posterior fascicular block Right bundle branch block and left anterior fascicular block Other bilateral bundle branch block Trifascicular block Lown-Ganong-Levine syndrome Long QT syndrome Other specified conduction disorder Atrial fibrillation Atrial flutter 41091 41092 41181 41189 41400 41401 41402 41403 41404 41405 41406 41407 41410 41411 41412 41419 41511 41512 41519 42090 42091 42099 42290 42291 42490 42491 42499 42511 42518 42610 42611 42612 42613 42650 42651 42652 42653 42654 42681 42682 42689 42731 42732 59 Ventricular fibrillation Ventricular flutter Unspecified premature beats Supraventricular premature beats Other premature beats Sinoatrial node dysfunction Other specified cardiac dysrhythmias Unspecified systolic heart failure Acute systolic heart failure Chronic systolic heart failure Acute on chronic systolic heart failure Unspecified diastolic heart failure Acute diastolic heart failure Chronic diastolic heart failure Acute on chronic diastolic heart failure Unspecified combined systolic and diastolic heart failure Acute combined systolic and diastolic heart failure Chronic combined systolic and diastolic heart failure Acute on chronic combined systolic and diastolic heart failure Acquired cardiac septal defect Other certain sequelae of myocardial infarction, not elsewhere classified Other disorders of papillary muscle Hyperkinetic heart disease Takotsubo syndrome Other ill-defined heart disease Occlusion and stenosis of basilar artery without mention of cerebral infarction Occlusion and stenosis of basilar artery with cerebral infarction Occlusion and stenosis of carotid artery without mention of cerebral infarction Occlusion and stenosis of carotid artery with cerebral infarction Occlusion and stenosis of vertebral artery without mention of cerebral infarction Occlusion and stenosis of vertebral artery with cerebral infarction Occlusion and stenosis of multiple and bilateral precerebral arteries without mention of c Occlusion and stenosis of multiple and bilateral precerebral arteries with cerebral infarc Occlusion and stenosis of other specified precerebral artery without mention of cerebral i Occlusion and stenosis of other specified precerebral artery with cerebral infarction Occlusion and stenosis of unspecified precerebral artery without mention of cerebral infar Occlusion and stenosis of unspecified precerebral artery with cerebral infarction Cerebral thrombosis without mention of cerebral infarction Cerebral thrombosis with cerebral infarction 42741 42742 42760 42761 42769 42781 42789 42820 42821 42822 42823 42830 42831 42832 42833 42840 42841 42842 42843 42971 42979 42981 42982 42983 42989 43300 43301 43310 43311 43320 43321 43330 43331 43380 43381 43390 43391 43400 43401 60 Cerebral embolism without mention of cerebral infarction Cerebral embolism with cerebral infarction Unspecified cerebral artery occlusion without mention of cerebral infarction Unspecified cerebral artery occlusion with cerebral infarction Hemiplegia affecting unspecified side due to cerebrovascular disease Atherosclerosis of native arteries of the extremities, unspecified Atherosclerosis of native arteries of the extremities with intermittent claudication Atherosclerosis of native arteries of the extremities with rest pain Atherosclerosis of native arteries of the extremities with ulceration Atherosclerosis of native arteries of the extremities with gangrene Other atherosclerosis of native arteries of the extremities Atherosclerosis of unspecified bypass graft of extremities Atherosclerosis of autologous vein bypass graft of extremities Dissecting aortic aneurysm (any part), unspecified site Dissecting aortic aneurysm (any part), thoracic Dissecting aortic aneurysm (any part), abdominal Dissecting aortic aneurysm (any part), thoracoabdominal Aneurysm of artery of neck Aneurysm of splenic artery Aneurysm of other visceral artery Aneurysm of other specified artery Dissection of carotid artery Dissection of other artery Peripheral angiopathy in diseases classified elsewhere Embolism and thrombosis of arteries of upper extremity Embolism and thrombosis of arteries of lower extremity Embolism and thrombosis of iliac artery Embolism and thrombosis of other specified artery Atheroembolism of lower extremity Venous embolism and thrombosis of unspecified deep vessels of lower extremity Venous embolism and thrombosis of deep vessels of proximal lower extremity Venous embolism and thrombosis of deep vessels of distal lower extremity Chronic venous embolism and thrombosis of unspecified deep vessels of lower extremity Chronic venous embolism and thrombosis of deep vessels of proximal lower extremity Chronic venous embolism and thrombosis of deep vessels of distal lower extremity Acute venous embolism and thrombosis of superficial veins of upper extremity Acute venous embolism and thrombosis of deep veins of upper extremity Acute venous embolism and thrombosis of upper extremity, unspecified Acute venous embolism and thrombosis of subclavian veins Acute venous embolism and thrombosis of internal jugular veins Hypotension of hemodialysis 43410 43411 43490 43491 43820 44020 44021 44022 44023 44024 44029 44030 44031 44100 44101 44102 44103 44281 44283 44284 44289 44321 44329 44381 44421 44422 44481 44489 44502 45340 45341 45342 45350 45351 45352 45381 45382 45383 45385 45386 45821 61 Other iatrogenic hypotension Acute tracheitis without mention of obstruction Acute bronchiolitis due to respiratory syncytial virus (RSV) Acute bronchiolitis due to other infectious organisms Obstructive chronic bronchitis, with (acute) exacerbation Obstructive chronic bronchitis with acute bronchitis Extrinsic asthma, unspecified Extrinsic asthma with status asthmaticus Extrinsic asthma, with (acute) exacerbation Intrinsic asthma, unspecified Intrinsic asthma with status asthmaticus Intrinsic asthma, with (acute) exacerbation Chronic obstructive asthma with status asthmaticus Chronic obstructive asthma, with (acute) exacerbation Cough variant asthma Asthma, unspecified, unspecified status Asthma, unspecified with status asthmaticus Asthma, unspecified, with (acute) exacerbation Malignant pleural effusion Other specified forms of effusion, except tuberculous Other pneumothorax Acute respiratory failure following trauma and surgery Acute respiratory failure Other pulmonary insufficiency, not elsewhere classified Chronic respiratory failure Acute and chronic respiratory failure Other diseases of lung, not elsewhere classified Unspecified tracheostomy complication Mechanical complication of tracheostomy Other tracheostomy complications Acute bronchospasm Other diseases of trachea and bronchus Mucositis (ulcerative) due to antineoplastic therapy Unspecified esophagitis Reflux esophagitis Acute esophagitis Other esophagitis Ulcer of esophagus with bleeding Esophageal hemorrhage Acute gastric ulcer with hemorrhage, without mention of obstruction Acute gastric ulcer with perforation, without mention of obstruction Chronic or unspecified gastric ulcer with hemorrhage, without mention of obstruction 45829 46410 46611 46619 49121 49122 49300 49301 49302 49310 49311 49312 49321 49322 49382 49390 49391 49392 51181 51189 51289 51851 51881 51882 51883 51884 51889 51900 51902 51909 51911 51919 52801 53010 53011 53012 53019 53021 53082 53100 53110 53140 62 Chronic or unspecified gastric ulcer with hemorrhage and obstruction Chronic or unspecified gastric ulcer with perforation, without mention of obstruction Chronic or unspecified gastric ulcer with hemorrhage and perforation, without mention of obstruction Gastric ulcer, unspecified as acute or chronic, without mention of hemorrhage, perforation Acute duodenal ulcer with hemorrhage, without mention of obstruction Acute duodenal ulcer with hemorrhage and perforation, without mention of obstruction Duodenal ulcer, chronic or unspecified, with hemorrhage, without mention of obstruction Chronic or unspecified duodenal ulcer with hemorrhage and obstruction Chronic or unspecified duodenal ulcer with perforation, without mention of obstruction Chronic or unspecified duodenal ulcer with hemorrhage and perforation, without mention of obstruction Acute peptic ulcer, unspecified site, with hemorrhage, without mention of obstruction Chronic or unspecified peptic ulcer, unspecified site, with hemorrhage, without mention of obstruction Chronic or unspecified gastrojejunal ulcer with hemorrhage, without mention of obstruction Acute gastritis with hemorrhage Atrophic gastritis with hemorrhage Alcoholic gastritis without mention of hemorrhage Alcoholic gastritis with hemorrhage Other specified gastritis with hemorrhage Unspecified gastritis and gastroduodenitis with hemorrhage Duodenitis with hemorrhage Angiodysplasia of stomach and duodenum with hemorrhage Dieulafoy lesion (hemorrhagic) of stomach and duodenum Inguinal hernia with gangrene, unilateral or unspecified, (not specified as recurrent) Femoral hernia with gangrene, unilateral or unspecified (not specified as recurrent) Gallstone ileus Fecal impaction Intestinal or peritoneal adhesions with obstruction (postoperative) (postinfection) Other specified intestinal obstruction Diverticulosis of small intestine with hemorrhage Diverticulosis of colon with hemorrhage Diverticulitis of colon with hemorrhage Spontaneous bacterial peritonitis Perforation of intestine 53141 53150 53160 53190 53200 53220 53240 53241 53250 53260 53300 53340 53440 53501 53511 53530 53531 53541 53551 53561 53783 53784 55000 55100 56031 56032 56081 56089 56202 56212 56213 56723 56983 63 Angiodysplasia of intestine with hemorrhage Dieulafoy lesion (hemorrhagic) of intestine Calculus of gallbladder with acute cholecystitis, without mention of obstruction Calculus of gallbladder with acute cholecystitis and obstruction Calculus of gallbladder with other cholecystitis, without mention of obstruction Calculus of gallbladder with other cholecystitis and obstruction Calculus of bile duct with acute cholecystitis without mention of obstruction Calculus of bile duct with acute cholecystitis and obstruction Calculus of gallbladder and bile duct with acute cholecystitis, with obstruction Calculus of gallbladder and bile duct with other cholecystitis, with obstruction Calculus of gallbladder and bile duct with acute and chronic cholecystitis, without mention of obstruction Calculus of gallbladder and bile duct with acute and chronic cholecystitis, with obstruction Cholecystitis, unspecified Chronic cholecystitis Acute and chronic cholecystitis Gross hematuria Peyronie's disease Mastodynia Pyogenic arthritis, lower leg Rheumatoid lung Pain in joint, shoulder region Necrotizing fasciitis Rhabdomyolysis Panniculitis of other sites Swelling of limb Acute osteomyelitis, site unspecified Acute osteomyelitis, lower leg Acute osteomyelitis, ankle and foot Acute osteomyelitis, other specified site Chronic osteomyelitis, pelvic region and thigh Chronic osteomyelitis, lower leg Chronic osteomyelitis, ankle and foot Chronic osteomyelitis, other specified sites Unspecified osteomyelitis, site unspecified Unspecified osteomyelitis, hand Unspecified osteomyelitis, pelvic region and thigh Unspecified osteomyelitis, other specified sites Pathologic fracture of humerus Pathologic fracture of neck of femur Pathologic fracture of other specified part of femur Pathologic fracture of other specified site 56985 56986 57400 57401 57410 57411 57430 57431 57461 57471 57480 57481 57510 57511 57512 59971 60785 61171 71106 71481 71941 72886 72888 72939 72981 73000 73006 73007 73008 73015 73016 73017 73018 73020 73024 73025 73028 73311 73314 73315 73319 64 Aseptic necrosis of bone, site unspecified Aseptic necrosis of head of humerus Aseptic necrosis of head and neck of femur Aseptic necrosis of other bone site Stress fracture of femoral neck Complete transposition of great vessels Transposition of great vessels, double outlet right ventricle Corrected transposition of great vessels Unspecified type congenital endocardial cushion defect Ostium primum defect Other congenital endocardial cushion defect Unspecified congenital pulmonary valve anomaly Congenital atresia of pulmonary valve Congenital stenosis of pulmonary valve Other congenital anomalies of pulmonary valve Congenital subaortic stenosis Congenital coronary artery anomaly Congenital heart block Congenital malposition of heart and cardiac apex Other specified congenital anomaly of heart Coarctation of aorta (preductal) (postductal) Unspecified congenital anomaly of aorta Congenital atresia and stenosis of aorta Other congenital anomaly of aorta Congenital anomaly of the peripheral vascular system, unspecified site Congenital anomaly of cerebrovascular system Marfan's syndrome Other specified multiple congenital anomalies, so described Coma Transient alteration of awareness Other alteration of consciousness Hypothermia not associated with low environmental temperature Memory loss Generalized pain Altered mental status Failure to thrive Jaw pain Unspecified shock Cardiogenic shock Septic shock Other shock without mention of trauma Unspecified respiratory abnormality Orthopnea 73340 73341 73342 73349 73396 74510 74511 74512 74560 74561 74569 74600 74601 74602 74609 74681 74685 74686 74687 74689 74710 74720 74722 74729 74760 74781 75982 75989 78001 78002 78009 78065 78093 78096 78097 78341 78492 78550 78551 78552 78559 78600 78602 65 Apnea Cheyne-Stokes respiration Shortness of breath Tachypnea Wheezing Other dyspnea and respiratory abnormalities Hemoptysis unspecified Other hemoptysis Precordial pain Painful respiration Chest pain, other Abdominal pain, unspecified site Abdominal pain, right upper quadrant Abdominal pain, left upper quadrant Abdominal pain, right lower quadrant Abdominal pain, left lower quadrant Abdominal pain, periumbilic Abdominal pain, epigastric Abdominal pain, generalized Abdominal pain, other specified site Malignant ascites Abdominal tenderness, unspecified site Abdominal tenderness, right upper quadrant Abdominal tenderness, right lower quadrant Abdominal tenderness, left lower quadrant Abdominal tenderness, epigastric Abdominal tenderness, generalized Abdominal tenderness, other specified site Other abnormal glucose Abnormal arterial blood gases Other nonspecific findings on examination of blood Abnormal findings lung field other Nonspecific abnormal electroencephalogram (EEG) Nonspecific abnormal unspecified cardiovascular function study Nonspecific abnormal electrocardiogram (ECG) (EKG) Other nonspecific abnormal cardiovascular system function study Hypoxemia Closed fracture of base of skull without mention of intracranial injury, unspecified state Closed fracture of base of skull without mention of intracranial injury, no loss of consciousness Closed fracture of base of skull without mention of intracranial injury, loss of consciousness Closed fracture of base of skull with subarachnoid, subdural, and extradural 78603 78604 78605 78606 78607 78609 78630 78639 78651 78652 78659 78900 78901 78902 78903 78904 78905 78906 78907 78909 78951 78960 78961 78963 78964 78966 78967 78969 79029 79091 79099 79319 79402 79430 79431 79439 79902 80100 80101 80106 80120 66 hemorrhage, unspecified state of consciousness Closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, with no loss of consciousness Closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, with brief [less than one hour] loss of consciousness) Closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, with loss of consciousness of unspecified duration Closed fracture of third cervical vertebra without mention of spinal cord injury Closed fracture of fourth cervical vertebra without mention of spinal cord injury Closed fracture of fifth cervical vertebra without mention of spinal cord injury Closed fracture of seventh cervical vertebra without mention of spinal cord injury Closed fracture of multiple cervical vertebrae without mention of spinal cord injury Closed fracture of C1-C4 level with unspecified spinal cord injury Closed fracture of C5-C7 level with unspecified spinal cord injury Closed fracture of T7-T12 level with unspecified spinal cord injury Closed fracture of rib(s), unspecified Closed fracture of one rib Closed fracture of two ribs Closed fracture of three ribs Closed fracture of four ribs Closed fracture of five ribs Closed fracture of six ribs Closed fracture of seven ribs Closed fracture of eight or more ribs Closed fracture of multiple ribs, unspecified Closed fracture of ilium Closed fracture of ischium Multiple closed pelvic fractures with disruption of pelvic circle Unspecified part of closed fracture of clavicle Closed fracture of shaft of clavicle Closed fracture of acromial end of clavicle Closed fracture of unspecified part of scapula Closed fracture of glenoid cavity and neck of scapula Closed fracture of unspecified part of upper end of humerus Closed fracture of surgical neck of humerus Closed fracture of anatomical neck of humerus Closed fracture of greater tuberosity of humerus Other closed fractures of upper end of humerus Closed fracture of unspecified part of humerus Closed fracture of shaft of humerus Closed fracture of unspecified part of lower end of humerus Closed fracture of supracondylar humerus Closed fracture of unspecified condyle(s) of humerus 80121 80122 80126 80503 80504 80505 80507 80508 80600 80605 80625 80700 80701 80702 80703 80704 80705 80706 80707 80708 80709 80841 80842 80843 81000 81002 81003 81100 81103 81200 81201 81202 81203 81209 81220 81221 81240 81241 81244 67 Other closed fracture of lower end of humerus Closed fracture of unspecified intracapsular section of neck of femur Closed fracture of epiphysis (separation) (upper) of neck of femur Closed fracture of midcervical section of femur Closed fracture of base of neck of femur Other closed transcervical fracture of femur Closed fracture of unspecified trochanteric section of femur Closed fracture of intertrochanteric section of femur Closed fracture of subtrochanteric section of femur Open fracture of intertrochanteric section of femur Closed fracture of unspecified part of femur Closed fracture of shaft of femur Closed fracture of unspecified part of lower end of femur Closed fracture of femoral condyle Closed supracondylar fracture of femur Other closed fracture of lower end of femur Open fracture of unspecified part of lower end of femur Open supracondylar fracture of femur Closed anterior dislocation of humerus Concussion, with loss of consciousness of 30 minutes or less Cerebellar or brain stem contusion without mention of open intracranial wound, no loss of consciousness Other and unspecified cerebral laceration and contusion, without mention of open intracranial wound, unspecified state of consciousness Other and unspecified cerebral laceration and contusion, without mention of open intracranial wound, with no loss of consciousness Subarachnoid hemorrhage following injury, without mention of open intracranial wound, unspecified state of consciousness Subarachnoid hemorrhage following injury, without mention of open intracranial wound, no loss of consciousness Subarachnoid hemorrhage following injury, without mention of open intracranial wound, brief loss of consciousness Subarachnoid hemorrhage following injury, without mention of open intracranial wound, loss of consciousness Subdural hemorrhage following injury, without mention of open intracranial wound, unspecified state of consciousness Subdural hemorrhage following injury, without mention of open intracranial wound, no loss of consciousness Subdural hemorrhage following injury, without mention of open intracranial wound, brief loss of consciousness Subdural hemorrhage following injury, without mention of open intracranial wound, without mention of open intracranial wound, with prolonged [more than 24 hours] loss of consciousness without return to pre-existing conscious level Subdural hemorrhage following injury, without mention of open intracranial wound, loss of consciousness 81249 82000 82001 82002 82003 82009 82020 82021 82022 82031 82100 82101 82120 82121 82123 82129 82130 82133 83101 85011 85141 85180 85181 85200 85201 85202 85206 85220 85221 85222 85225 85226 68 Subdural hemorrhage following injury, without mention of open intracranial wound, unspecified state of consciousness Extradural hemorrhage following injury, without mention of open intracranial wound, unspecified state of consciousness Extradural hemorrhage following injury, without mention of open intracranial wound, no loss of consciousness Other and unspecified intracranial hemorrhage following injury, without mention of open intracranial wound, unspecified state of consciousness Other and unspecified intracranial hemorrhage following injury, without mention of open intracranial wound, with no loss of consciousness Other and unspecified intracranial hemorrhage following injury, without mention of open intracranial wound, with brief [less than one hour] loss of consciousness Other and unspecified intracranial hemorrhage following injury without mention of open intracranial wound, with prolonged [more than 24 hours] loss of consciousness without return to pre-existing conscious level Intracranial injury of other and unspecified nature, without mention of open intracranial wound, unspecified state of consciousness Intracranial injury of other and unspecified nature, without mention of open intracranial wound, with no loss of consciousness Intracranial injury of other and unspecified nature, without mention of open intracranial wound, with brief [less than one hour] loss of consciousness Intracranial injury of other and unspecified nature, without mention of open intracranial wound, with loss of consciousness of unspecified duration Unspecified injury to heart without mention of open wound into thorax Heart contusion without mention of open wound into thorax Lung contusion without mention of open wound into thorax Injury to other specified intrathoracic organs without mention of open wound into cavity Massive parenchymal disruption of spleen without mention of open wound into cavity Contusion of shoulder region C1-C4 level with central cord syndrome Other injury of chest wall Poisoning by opium (alkaloids), unspecified Poisoning by heroin Poisoning by methadone Poisoning by opiates and related narcotics, other Poisoning by propionic acid derivatives Poisoning antidepressants unspec Poisoning SSRI Poisoning tricyclic antidepress Poisoning antidepressants other Poisoning by amphetamines Poisoning by cocaine Toxic effect of tobacco Toxic effect of other substances 85229 85240 85241 85300 85301 85302 85305 85400 85401 85402 85406 86100 86101 86121 86229 86504 92300 95203 95911 96500 96501 96502 96509 96561 96900 96903 96905 96909 96972 97081 98984 98989 69 Unspecified adverse effect of unspecified drug, medicinal and biological substance Unspecified adverse effect of insulin Unspecified adverse effect of other drug, medicinal and biological substance Sepsis Severe sepsis Mechanical complication of unspecified cardiac device, implant, and graft Mechanical complication due to cardiac pacemaker (electrode) Mechanical complication due to heart valve prosthesis Mechanical complication due to coronary bypass graft Mechanical complication due to automatic implantable cardiac defibrillator Mechanical complication of cardiac device, implant, and graft, other Mechanical complication due to other tissue graft, not elsewhere classified Mechanical complication due to other implant and internal device, not elsewhere classified Infection and inflammatory reaction due to unspecified device, implant, and graft Infection and inflammatory reaction due to cardiac device, implant, and graft Infection and inflammatory reaction due to other vascular device, implant, and graft Infection and inflammatory reaction due to peritoneal dialysis catheter Other complications due to heart valve prosthesis Other complications due to other cardiac device, implant, and graft Other complications due to renal dialysis device, implant, and graft Other complications due to other vascular device, implant, and graft Complications of transplanted kidney Complications of transplanted liver Complications of transplanted heart Complications of transplanted lung Central nervous system complication Iatrogenic cerebrovascular infarction or hemorrhage Other respiratory complications Infection (chronic) of amputation stump Other late amputation stump complication Vascular complications of other vessels Hemorrhage complicating a procedure Cataract fragments in eye following surgery Complications of medical care, NEC, infection due to central venous catheter Bloodstream infection central line Fall from other slipping, tripping, or stumbling Unspecified fall Antineoplastic and immunosuppressive drugs causing adverse effect in therapeutic use Cardiac rhythm regulators causing adverse effect in therapeutic use Asymptomatic human immunodeficiency virus (HIV) infection status 99520 99523 99529 99591 99592 99600 99601 99602 99603 99604 99609 99652 99659 99660 99661 99662 99668 99671 99672 99673 99674 99681 99682 99683 99684 99701 99702 99739 99762 99769 99779 99811 99882 99931 99932 E8859 E8889 E9331 E9420 V08 70 Personal history of malignant neoplasm of large intestine Personal history of malignant neoplasm of rectum, rectosigmoid junction, and anus Personal history of malignant neoplasm of bronchus and lung Personal history of malignant neoplasm of breast Personal history of malignant neoplasm of ovary Personal history of malignant neoplasm of prostate Personal history of malignant neoplasm of bladder Personal history of sudden cardiac arrest Personal history of transient ischemic attack [TIA], and cerebral infarction without resid Personal history of other diseases of circulatory system Personal history of surgery to heart and great vessels, presenting hazards to health Personal history of fall Other mental problems Kidney replaced by transplant Heart replaced by transplant Heart valve replaced by transplant Lung replaced by transplant Liver replaced by transplant Bone marrow replaced by transplant Organ or tissue replaced by other means, Heart assist device Heart valve replaced by other means Blood vessel replaced by other means Unspecified cardiac device in situ Cardiac pacemaker in situ Automatic implantable cardiac defibrillator in situ Other specified cardiac device in situ Renal dialysis status Renal dialysis status Postprocedural aortocoronary bypass status Postprocedural percutaneous transluminal coronary angioplasty status Other cardiorespiratory problems Fitting and adjustment of cardiac pacemaker Fitting and adjustment of automatic implantable cardiac defibrillator Fitting and adjustment of other cardiac device Attention to tracheostomy Encounter for extracorporeal dialysis Fitting and adjustment of extracorporeal dialysis catheter Fitting and adjustment of peritoneal dialysis catheter Radiotherapy Encounter for antineoplastic chemotherapy Encounter for antineoplastic immunotherapy V1005 V1006 V1011 V103 V1043 V1046 V1051 V1253 V1254 V1259 V151 V1588 V402 V420 V421 V422 V426 V427 V4281 V4321 V433 V434 V4500 V4501 V4502 V4509 V451 V4511 V4581 V4582 V472 V5331 V5332 V5339 V550 V560 V561 V562 V580 V5811 V5812 71 Aftercare following surgery for neoplasm Aftercare following organ transplant Encounter for long-term (current) use of other medications Fitting and adjustment of vascular catheter Encounter for therapeutic drug monitoring Kidney donor Suicidal ideation Chemotherapy follow-up examination Follow-up examination following completed treatment with high-risk medications, not elsewhere classifed Issue of repeat prescriptions Other and unspecified general psychiatric examination Examination of participant in clinical trial Observation of other suspected mental condition Observation for suspected malignant neoplasm Observation for suspected cardiovascular disease V5842 V5844 V5869 V5881 V5883 V594 V6284 V672 V6751 V681 V702 V707 V7109 V711 V717 72 Don’t screen women older than 65 years of age for cervical cancer who have had adequate prior screening and are not otherwise at high risk for cervical cancer Choosing Wisely Guidelines American Academy of Family Physicians Don’t screen women older than 65 years of age for cervical cancer who have had adequate prior screening and are not otherwise at high risk for cervical cancer. There is adequate evidence that screening women older than 65 years of age for cervical cancer who have had adequate prior screening and are not otherwise at high risk provides little to no benefit. Methods We calculated the percent of female Medicare beneficiaries over age 65 at low risk for cervical cancer who received at least one cervical cancer screening test for each calendar year 2006-11. We then created a weighted average of imaging prevalence for the interval 2006-11. We required enrollment in fee-for-service Medicare Parts A and B for at least 11 months in each calendar year. Beneficiaries were deemed to be at high risk for cervical cancer if they had two physician or one acute hospital claim for relevant diagnoses at any point during the study period, with the exception of claims indicating an abnormal pap test or HPV, where we only required one claim. References NQF-Endorsed National Voluntary Consensus Standards for Physician-Focused Ambulatory Care. National Committee for Quality Assurance. 2008. CCS and ICD-9 Codes for Excluding Patients at High Risk for Cervical Cancer Label Gynecological cancers HIV / AIDS Diethylstilbestrol exposure Abnormal Pap Test / HPV Code CCS 25-28 CCS 5 ICD-9 760.76 ICD-9 795.0x, 795.1x, V72.32 CPT Codes for Identifying Cervical Cancer Tests Label Cytopathology cervical/vaginal req interp physician Cytopathology cerv/vag auto thin layer prep mnl screen Cytopathology c/v flu auto thin mnl scr&rescr phys Cytopathology smrs c/v scr automated system phys supv Cytopathology smrs c/v scr auto sys mnl rescr phys Cytopathology slides c/v mnl scr under phys Cytopathology slides c/v mnl scr&cptr rescr phys Cytopathology slides c/v mnl scr&rescr phys Cytopathology slides c/v mnl scr&cptr-rescr cell s&i Cytopathology slides c/v definitive hormonal eval Code 88141 88142 88143 88147 88148 88150 88152 88153 88154 88155 73 Cytopathology slides c/v mnl scr&rescr phys supv Cytopathology slides c/v mnl scr&cptr rescr phys supv Cytopathology fine ndl aspirate immt cytohist std dx 1st Cytopathology eval fine needle aspirate interp & report Cytopathology c/v auto thin lyr prepj scr sys phys Cytopathology c/v auto thin lyr prepj scr mnl rescr phys 88164 88165 88166 88167 88174 88175 74 Don’t routinely repeat dual-energy x-ray absorptiometry (DXA) scans more often than once every two years Choosing Wisely Guidelines American College of Rheumatology Don’t routinely repeat DXA scans more often than once every two years. Initial screening for osteoporosis should be performed according to National Osteoporosis Foundation recommendations. The optimal interval for repeating Dual-energy X-ray Absorptiometry (DXA) scans is uncertain, but because changes in bone density over short intervals are often smaller than the measurement error of most DXA scanners, frequent testing (e.g., <2 years) is unnecessary in most patients. Even in high-risk patients receiving drug therapy for osteoporosis, DXA changes do not always correlate with probability of fracture. Therefore, DXAs should only be repeated if the result will influence clinical management or if rapid changes in bone density are expected. Recent evidence also suggests that healthy women age 67 and older with normal bone mass may not need additional DXA testing for up to ten years provided osteoporosis risk factors do not significantly change. Methods We calculated the proportion of DXA tests performed on female Medicare beneficiaries over age 66 that were within 23 months of a previous DXA test (i.e., delivered at short interval) in each calendar year 2008-11. We then created a weighted average of testing prevalence for the interval 2008-11. We required beneficiaries to be enrolled in fee-for-service Medicare Parts A and B in the 23 months prior to each DXA test identified. We excluded beneficiaries who were (i) diagnosed with any cancer, except non-melanoma skin cancer (using the Clinical Classifications Software codes 11-22 and 24-44) and (ii) diagnosed with fragility fracture in the 23 months prior to the DXA. Fragility fractures were defined as follows: (i) at least one CPT code for hip fracture repair; (ii) at least one diagnosis code for distal radius or proximal humerus fracture, plus at least one upper extremity radiography claim within seven days (plus or minus) of the diagnosis claim date; or (iii) at least one ICD-9 diagnosis code for vertebral fracture. CPT Codes for Identifying DXA Tests Label Dual energy x-ray absorptiometry body composition study, one or more sites Bone density study Bone density appendicular Bone density study Bone density appendicular Code 0028T 76075 76076 77080 77081 ICD-9 and CPT Codes for Identifying Fragility Fractures. Label Hip fracture Code CPT 27230-27248 75 Wrist fracture Humerus fracture Vertebral fracture Shoulder/clavicle imaging Humerus/elbow imaging Forearm/wrist imaging Hand imaging CT MRI ICD-9 813.4-813.54, 814.00, 814.10 and CPT 25600, 25605, 25609, 25611 ICD-9 812.0-812.19 and CPT 2360023630, 23665-23680 ICD-9 805.2. 805.4, 805.8, 733.13 CPT 73000, 73010, 73020, 73030, 73040, 73050 CPT 73060, 73070, 73080, 73085 CPT 73090, 73092, 73100, 73110, 73115 CPT 73120, 73130, 73140 CPT 73200, 73201, 73202, 73206 CPT 73218, 73219, 73220, 73221, 73222, 73223, 73225 76 Don't perform preoperative cardiac tests for cataract surgeries Choosing Wisely Guidelines American Academy of Ophthalmology American College of Cardiology Society of General Internal Medicine Don’t perform preoperative medical tests for eye surgery unless there are specific medical indications. For many, preoperative tests are not necessary because eye surgeries are not lengthy and don’t pose serious risks. An EKG should be ordered if patients have heart disease. A blood glucose test should be ordered if patients have diabetes. A potassium test should be ordered if patients are on diuretics. In general, patients scheduled for surgery do not need medical tests unless the history or physical examination indicate the need for a test, e.g., the existence of conditions noted above. Institutional policies should consider these issues. Don’t perform stress cardiac imaging or advanced non-invasive imaging as a pre-operative assessment in patients scheduled to undergo low-risk non-cardiac surgery. Non-invasive testing is not useful for patients undergoing low-risk non-cardiac surgery (e.g., cataract removal). These types of tests do not change the patient’s clinical management or outcomes and will result in increased costs. Don’t perform routine pre-operative testing before low-risk surgical procedures. Pre-operative assessment is expected before all surgical procedures. This assessment includes an appropriately directed and sufficiently comprehensive history and physical examination, and, in some cases, properly includes laboratory and other testing to help direct management and assess surgical risk. However, pre-operative testing for low-risk surgical procedures (such as cataract extraction) results in unnecessary delays and adds to significant avoidable costs and should be eliminated. Methods We calculated the percent of Medicare beneficiaries over age 65 who received a non-indicated electrocardiogram, cardiovascular stress test (including stress imaging), echocardiogram, chest xray, or advanced cardiac imaging (CT, MRI, PET) in the 30 days before cataract surgery in each calendar year 2006-11. We then created a weighted average of testing prevalence for the interval 2006-11. We identified cataract surgery using the BETOS code P4B. We required enrollment in fee-for-service Medicare Parts A and B for at least 11 months during the calendar year. We did not count testing events if diagnosis codes in any of the first four fields on a claim involved cardiac disease, cardiac-related symptoms, or any conditions that might justify the test (e.g., respiratory conditions, cancer), and we excluded beneficiaries who were admitted in the 30 days before the surgery. References Physician Quality Reporting System (PQRS) Measure Specifications Manual for Claims and Registry Reporting of Individual Measures. Centers for Medicare and Medicaid Services. 2014. 77 CPT Codes for Identifying Cardiac Tests (Advanced Imaging, Cardiac Stress Tests, Echocardiograms, and Electrocardiograms) See codes applied to cardiac testing measure (pp. 7). CPT Codes for Identifying Chest X-Rays Label Chest x-ray 1 view frontal Chest x-ray stereo frontal Chest x-ray 2vw frontal&latl Chest x-ray frnt lat lordotc Chest x-ray frnt lat oblique Chest x-ray 4/> views Chest x-ray special views Code 71010 71015 71020 71021 71022 71030 71035 ICD-9 Codes for Excluding Advanced Imaging (CT, MRI, PET) Advanced imaging tests were excluded from the analysis if the associated primary, secondary, tertiary, or quaternary diagnosis involved: (i) cardiac conditions; (ii) respiratory conditions, except acute respiratory infections (e.g. pneumonia); (iii) acute central nervous system conditions, except headaches; (iv) all thoracic and non-thoracic arterial conditions, but not peripheral venous conditions such as deep venous thrombosis; (v) malignant hypertension; (vi) end stage renal disease and acute renal disease; (vii) abdominal pain; (viii) cancer; (ix) drug toxicity or poisoning; or (x) exertional stress and fatigue. Label Pulmonary diseases other mycobact Streptococcal septicemia Meth susc staph aureus septicemia Escherichia coli septicemia Mssa infection Mrsa infection Human immunodeficiency virus dis Unspecified viral infection Lyme disease Sarcoidosis Malignant neoplasm of upper lobe, bronchus, or lung Malignant neoplasm of bronchus and lung, unspecified site Oth malig neo ear skin external Malig neo skin oth uns parts face Oth malignant neo scalp/skin neck Oth malig neo skin l limb inc hip Oth malignant neo skin site uns Malignant neoplasm of breast (female), unspecified site Malignant neoplasm of prostate Code 0310 0380 03811 03842 04111 04112 042 07999 08881 135 1623 1629 1732 1733 1734 1737 1739 1749 185 78 Malignant neo thyroid gland Benign neoplasm bronchus/lung Benign neoplasm cerebral meninges Ca in situ breast Ca in situ prostate Uncert behavior neo intestine Uncert behavior neo lung Uncert behavior neo prostate Uncert behavior neo bladder Uncert behavior neo kidney Uncert behavior neo skin Uncert behavior neo breast Polycythemia vera Essential thrombocythemia Lo gr myelodysplastic synd lesions Respiratory unsp behavior neo Bone/skin unsp behavior neo Bladder unsp behavior neo Ot gu unsp behavior neo Brain unsp behavior neo Endonerv unsp behavior neo Unsp behavior neo Acute thyroiditis Diabetes hypersmolarity type ii Glucocorticoid deficiency Uns protein calorie malnutrition Disturb sulphur amino acid metabol Monoclonal paraproteinemia Disorders of iron metabolism Disorders magnesium metabolism Disorders phosphorus metabolism Uns disorder calcium metabolism Hypocalcemia Hypercalcemia Oth disorders calcium metabolism Hyperosmolality/or hypernatremia Hyposmolality/or hyponatremia Acidosis Volume depletion unspecified Dehydration Fluid overload Hyperpotassemia Hypopotassemia 193 2123 2252 2330 2334 2352 2357 2365 2367 23691 2382 2383 2384 23871 23872 2391 2392 2394 2395 2396 2397 2399 2450 25020 25541 2639 2704 2731 2750 2752 2753 27540 27541 27542 27549 2760 2761 2762 27650 27651 2766 2767 2768 79 Electrolyte/fluid disorders oth Autoimmune disease other Iron deficiency anemia blood loss Iron def anemia inadeq iron intake Other iron deficiency anemias Uns iron deficiency anemia Pernicious anemia Oth vitamin b12 deficiency anemia Folate deficiency anemia Other megaloblastic anemias oth Anemia w ot nutritional deficiency Uns deficiency anemia Uns acquired hemolytic anemia Pancytopenia Other aplastic anemias Sideroblastic anemia Anemia chronic kidney disease Anemia of other chronic disease Other specified anemias Anemia unspecified Defibrination syndrome Oth nonthrombocytopenic purpuras Primary thrombocytopenia unspec Immune thrombocytopenic purpura Uns thrombocytopenia Neutropenia unspecified Functional disord neutrophils Leukocytopenia unspecified Leukocytosis unspecified Other disease white blood cells Polycythemia secondary Ot dis blood/blood forming organs Uns dis blood/blood forming organs Delirium in other conditions Uns schizophrenia Depressive type psychosis Maj depress dis recurr epi uns Maj depress dis recur epi sev Bipolar i disorder unspecified Bipolar disorder unspecified Unspecified psychosis Anxiety state unspecified Panic disorder wo agoraphobia 2769 2794 2800 2801 2808 2809 2810 2811 2812 2813 2818 2819 2839 2841 2848 2850 28521 28529 2858 2859 2866 2872 28730 28731 2875 28800 2881 28850 28860 2888 2890 28989 2899 2930 29590 29620 29630 29633 2967 29680 2989 30000 30001 80 Generalized anxiety disorder Dysthymic disorder Psychosex dysfunc inhibited excite Oth/uns alcohol dependence uns Opioid type dependence uns Opioid type dependence continuous Unspec drug dependence uns Alcohol abuse unspec Oth mixed/uns drug abuse uns Adjustment disorder mixed Personality chg due to oth cond Depressive disorder other Obstructive hydrocephalus Other acute postoperative pain Multiple sclerosis Encephalopathy unspecified Metabolic encephalopathy Other visual disturbances Uns peripheral vertigo Benign paroxysmal position vertigo Unspecified septicemia Mitral stenosis Rheumatic mitral insufficiency Mitral stenosis with insufficiency Other and unspecified mitral valve diseases Rheumatic aortic stenosis Rheumatic aortic insufficiency Rheumatic aortic stenosis with insufficiency Other and unspecified rheumatic aortic diseases Mitral valve stenosis and aortic valve stenosis Mitral valve stenosis and aortic valve insufficiency Mitral valve insufficiency and aortic valve stenosis Mitral valve insufficiency and aortic valve insufficiency Multiple involvement of mitral and aortic valves Unspecified mitral and aortic valve diseases Diseases of tricuspid valve Rheumatic heart failure (congestive) Essential hypertension, malignant Malignant hypertensive heart disease without heart failure Malignant hypertensive heart disease with heart failure Benign hypertensive heart disease without heart failure Benign hypertensive heart disease with heart failure Unspecified hypertensive heart disease without heart failure 30002 3004 30272 30390 30400 30401 30490 30500 30590 30928 3101 311 3314 33818 340 34830 34831 3688 38610 38611 389 3940 3941 3942 3949 3950 3951 3952 3959 3960 3961 3962 3963 3968 3969 3970 39891 4010 40200 40201 40210 40211 40290 81 Hypertensive heart disease, unspecified, with heart failure Mal kid hyper w ckd stage i-iv Hypertensive heart and chronic kidney disease, malignant, without heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, malignant, with heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, benign, without heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, benign, without heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, benign, with heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, unspecified, without heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, unspecified, with heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, unspecified, without heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, unspecified, with heart failure and with chronic kidney disease stage V Acute myocardial infarction of anterolateral wall, episode of care unspecified Acute myocardial infarction of anterolateral wall, initial episode of care Acute myocardial infarction of anterolateral wall, subsequent episode of care Acute myocardial infarction of other anterior wall, episode of care unspecified Acute myocardial infarction of other anterior wall, initial episode of care Acute myocardial infarction of other anterior wall, subsequent episode of care Acute myocardial infarction of inferolateral wall, episode of care unspecified Acute myocardial infarction of inferolateral wall, initial episode of care Acute myocardial infarction of inferolateral wall, subsequent episode of care Acute myocardial infarction of inferoposterior wall, episode of care unspecified Acute myocardial infarction of inferoposterior wall, initial episode of care Acute myocardial infarction of inferoposterior wall, subsequent episode of care Acute myocardial infarction of other inferior wall, episode of care unspecified Acute myocardial infarction of other inferior wall, initial episode of care Acute myocardial infarction of other inferior wall, subsequent episode of care Acute myocardial infarction of other lateral wall, episode of care unspecified Acute myocardial infarction of other lateral wall, initial episode of care Acute myocardial infarction of other lateral wall, subsequent episode of care Acute myocardial infarction, subendocardial infarction, episode of care unspecified Acute myocardial infarction, subendocardial infarction, initial episode of care Acute myocardial infarction, subendocardial infarction, subsequent episode of care Acute myocardial infarction of other specified sites, episode of care unspecified Acute myocardial infarction of other specified sites, initial episode of care Acute myocardial infarction of other specified sites, subsequent episode of care 40291 40300 40400 40401 40410 40412 40413 40490 40491 40492 40493 41000 41001 41002 41010 41011 41012 41020 41021 41022 41030 41031 41032 41040 41041 41042 41050 41051 41052 41070 41071 41072 41080 41081 41082 82 Acute myocardial infarction, unspecified site, episode of care unspecified Acute myocardial infarction, unspecified site, initial episode of care Acute myocardial infarction, unspecified site, subsequent episode of care Postmyocardial infarction syndrome Intermediate coronary syndrome Acute coronary occlusion without myocardial infarction Other acute and subacute form of ischemic heart disease Old myocardial infarction Angina decubitus Prinzmetal angina Other and unspecified angina pectoris Coronary atherosclerosis of unspecified type of vessel, native or graft Coronary atherosclerosis of native coronary artery Coronary atherosclerosis of autologous vein bypass graft Coronary atherosclerosis of nonautologous biological bypass graft Coronary atherosclerosis of artery bypass graft Coronary atherosclerosis of unspecified type of bypass graft Coronary atherosclerosis, of native coronary artery of transplanted heart Coronary atherosclerosis, of bypass graft (artery) (vein) of transplanted heart Aneurysm of heart Aneurysm of coronary vessels Other aneurysm of heart Chronic total occlusion of coronary artery Coronary atherosclerosis due to lipid rich plaque Other specified forms of chronic ischemic heart disease Unspecified chronic ischemic heart disease Iatrogenic pulmonary embolism and infarction Other pulmonary embolism and infarction Primary pulmonary hypertension Other chronic pulmonary heart diseases Unspecified chronic pulmonary heart disease Unspecified acute pericarditis Acute idiopathic pericarditis Acute and subacute bacterial endocarditis Other specified diseases of pericardium Unspecified disease of pericardium Mitral valve disorders Aortic valve disorders Tricuspid valve disorders, specified as nonrheumatic Pulmonary valve disorders Endocarditis, valve unspecified, unspecified cause Endomyocardial fibrosis Hypertrophic obstructive cardiomyopathy 41090 41091 41092 4110 4111 41181 41189 412 4130 4131 4139 41400 41401 41402 41403 41404 41405 41406 41407 41410 41411 41419 4142 4143 4148 4149 41511 41519 4160 4168 4169 42090 42091 4210 4238 4239 4240 4241 4242 4243 42490 4250 4251 83 Other primary cardiomyopathies Alcoholic cardiomyopathy Cardiomyopathy in other diseases classified elsewhere Unspecified secondary cardiomyopathy Atrioventricular block, complete Unspecified atrioventricular block First degree atrioventricular block Mobitz (type) II atrioventricular block Other second degree atrioventricular block Left bundle branch hemiblock Other left bundle branch block Right bundle branch block Unspecified bundle branch block Right bundle branch block and left posterior fascicular block Right bundle branch block and left anterior fascicular block Other bilateral bundle branch block Other heart block Anomalous atrioventricular excitation Long QT syndrome Other specified conduction disorder Unspecified conduction disorder Paroxysmal supraventricular tachycardia Paroxysmal ventricular tachycardia Unspecified paroxysmal tachycardia Atrial fibrillation Atrial flutter Ventricular fibrillation Ventricular flutter Cardiac arrest Unspecified premature beats Supraventricular premature beats Other premature beats Sinoatrial node dysfunction Other specified cardiac dysrhythmias Unspecified cardiac dysrhythmia Congestive heart failure, unspecified Left heart failure Unspecified systolic heart failure Acute systolic heart failure Chronic systolic heart failure Acute on chronic systolic heart failure Unspecified diastolic heart failure Acute diastolic heart failure 4254 4255 4258 4259 4260 42610 42611 42612 42613 4262 4263 4264 42650 42651 42652 42653 4266 4267 42682 42689 4269 4270 4271 4272 42731 42732 42741 42742 4275 42760 42761 42769 42781 42789 4279 4280 4281 42820 42821 42822 42823 42830 42831 84 Chronic diastolic heart failure Acute on chronic diastolic heart failure Unspecified combined systolic and diastolic heart failure Acute combined systolic and diastolic heart failure Chronic combined systolic and diastolic heart failure Acute on chronic combined systolic and diastolic heart failure Unspecified heart failure Unspecified myocarditis Myocardial degeneration Unspecified cardiovascular disease Cardiomegaly Functional disturbances following cardiac surgery Acquired cardiac septal defect Other disorders of papillary muscle Hyperkinetic heart disease Other ill-defined heart disease Unspecified heart disease Subarachnoid hemorrhage Intracerebral hemorrhage Subdural hemorrhage Occlusion and stenosis of carotid artery without mention of cerebral infarction Occlusion and stenosis of carotid artery with cerebral infarction Occlusion vertebral artery wo infar Occlusion and stenosis of multiple and bilateral precerebral arteries without mention of c Cerebral embolism with cerebral infarction Unspecified cerebral artery occlusion without mention of cerebral infarction Unspecified cerebral artery occlusion with cerebral infarction Vertebral artery syndrome Other specified transient cerebral ischemias Unspecified transient cerebral ischemia Acute, but ill-defined, cerebrovascular disease Cerebral atherosclerosis Cerebral aneurysm nonruptured Uns cerebrovascular disease Vertigo Uns late effects cv disease Atherosclerosis of aorta Atherosclerosis of renal artery Atherosclerosis of native arteries of the extremities, unspecified Atherosclerosis of native arteries of the extremities with intermittent claudication Atherosclerosis of native arteries of the extremities with rest pain Atherosclerosis of native arteries of the extremities with ulceration 42832 42833 42840 42841 42842 42843 4289 4290 4291 4292 4293 4294 42971 42981 42982 42989 4299 430 431 4321 43310 43311 43320 43330 43411 43490 43491 4351 4358 4359 436 4370 4373 4379 43885 4389 4400 4401 44020 44021 44022 44023 85 Atherosclerosis of native arteries of the extremities with gangrene Atherosclerosis of other specified arteries Generalized and unspecified atherosclerosis Dissecting aortic aneurysm (any part), unspecified site Dissecting aortic aneurysm (any part), thoracic Dissecting aortic aneurysm (any part), abdominal Thoracic aneurysm without mention of rupture Abdominal aneurysm without mention of rupture Thoracoabdominal aneurysm without mention of rupture Aortic aneurysm of unspecified site without mention of rupture Raynaud's syndrome Other peripheral vascular disease Embolism and thrombosis of arteries of lower extremity Wegener's granulomatosis Giant cell arteritis Stricture of artery Other specified disorders of arteries and arterioles Unspecified disorders of arteries and arterioles Embolism/thrombosis inf vena cava Embolism/thrombosis uns site Orthostatic hypotension Other iatrogenic hypotension Unspecified hypotension Hemorrhage unspecified Acute upper resp infect oth sites Acute bronchitis Pneumonia adenovirus Pneumonia respiratory syncy virus Uns viral pneumonia Pneumococcal pneumonia Pneumonia other bacteria Uns bacterial pneumonia Bronchopneumonia organism unspec Pneumonia organism unspecified Influenza with pneumonia Influenza w oth respiratory manif Obstructive chronic bronchitis, without exacerbation Obstructive chronic bronchitis, with (acute) exacerbation Obst chr bronchitis w ac bronchitis Other emphysema Extrinsic asthma unspecified Ex asthma w exacerbation Chronic obstructive asthma, unspecified 44024 4408 4409 44100 44101 44102 4412 4414 4417 4419 4430 44389 44422 4464 4465 4471 4478 4479 4532 4539 4580 45829 4589 4590 4658 4660 4800 4801 4809 481 48289 4829 485 486 4870 4871 49120 49121 49122 4928 49300 49302 49320 86 Chronic obst asthma w status asthm Chronic obstructive asthma, with (acute) exacerbation Asthma, unspecified, unspecified status Uns asthma w status asthmaticus Asthma, unspecified, with (acute) exacerbation Bronchiectasis w acute exacerb Chronic airway obstruction, not elsewhere classified Pneumonitis inhalation food Pleurisy without mention of effusion or current tuberculosis Other effusion not tuberculous Unspecified pleural effusion Pulmonary congestion and hypostasis Postinflammatory pulmonary fibrosis Other alveolar pneumonopathy Uns alveolar pneumonopathy Pulmonary collapse Unspecified acute edema of lung Pulmonary insuffic trauma surgery Acute respiratory failure Other pulmonary insufficiency, not elsewhere classified Acute and chronic respiratory failure Other diseases of lung, not elsewhere classified Acute bronchospasm Oth diseases trachea/bronchus Disorders diaphragm Oth diseases respiratory system Uns disease respiratory system Unspecified disease of the jaws Uns esophagitis Reflux esophagitis Oth esophagitis Acute gastritis wohemorrhage Uns ulcerative colitis Acute cholecystitis Acute pancreatitis Hematemesis Celiac disease Unspecified acute renal failure End stage renal disease Diffuse cystic mastopathy Mastodynia Lump or mass in breast Oth signs/symptoms in breast 49321 49322 49390 49391 49392 4941 496 5070 5110 5118 5119 514 515 5168 5169 5180 5184 5185 51881 51882 51884 51889 51911 51919 5194 5198 5199 5269 53010 53011 53019 53500 5569 5750 5770 5780 5790 5849 5856 6101 61171 61172 61179 87 Postmenopausal bleeding Lupus erythematosus Psoriatic arthropathy Oth psoriasis Systemic sclerosis Sicca syndrome Uns diffuse connect tissue disease Pyogenic arthritis shoulder Rheumatoid arthritis Rheumatoid arthritis visceral/syst Uns inflammatory polyarthropathy Uns polyarthrit/arthropth site uns Effusion of joint shoulder Difficulty in walking Degenerat thoracic iv disc Oth syndromes affecting cervical Pain in thoracic spine Lumbago Uns thoracic/lumb neuritis/radicul Unspecified backache Oth symptoms referable to back Polymyalgia rheumatica Oth affections shoulder region Muscle weakness (generalized) Rhabdomyolysis Rheumatism uns/fibrositis Unspecified myalgia and myositis Swelling of limb Acute osteomyelitis oth sites Uns osteomyelitis site uns Uns osteomyelitis oth sites Pathological fracture vertebrae Tietze's disease Kyphosis Scoliosis oth conditions Acquired deformity chest/rib Oth acquired deformity back/spine Tetralogy of Fallot Ventricular septal defect Ostium secundum type atrial septal defect Congenital stenosis of aortic valve Congenital insufficiency of aortic valve Congenital mitral insufficiency 6271 6954 6960 6961 7101 7102 7109 71101 7140 7142 7149 71650 71901 7197 72251 7238 7241 7242 7244 7245 7248 725 7262 72887 72888 7290 7291 72981 73008 73020 73028 73313 7336 73710 73743 7383 7385 7452 7454 7455 7463 7464 7466 88 Congenital coronary artery anomaly Other specified congenital anomaly of heart Unspecified congenital anomaly of heart Congenital atresia and stenosis of aorta Oth anomalies aorta Uns anomaly lung Anomalies diaphragm Transient alteration of awareness Other alteration of consciousness Syncope and collapse Dizziness and giddiness Fever Fever unspecified Chronic fatigue syndrome Other malaise and fatigue Memory loss Altered mental status Localized superficial swelling Edema Spontaneous ecchymoses Loss of weight Headache Swelling/mass/lump in head/neck Epistaxis Jaw pain Unspecified tachycardia Palpitations Undiagnosed cardiac murmurs Other abnormal heart sounds Unspecified shock Cardiogenic shock Other shock without mention of trauma Enlargement of lymph nodes Other symptoms involving cardiovascular system Unspecified respiratory abnormality Hyperventilation Orthopnea Apnea Shortness of breath Tachypnea Wheezing Other dyspnea and respiratory abnormalities Cough 74685 74689 7469 74722 74729 74860 7566 78002 78009 7802 7804 7806 78060 78071 78079 78093 78097 7822 7823 7827 78321 7840 7842 7847 78492 7850 7851 7852 7853 78550 78551 78559 7856 7859 78600 78601 78602 78603 78605 78606 78607 78609 7862 89 Hemoptysis unspecified Chest pain, unspecified Precordial pain Painful respiration Chest pain, other Swelling/mass/lump in chest Other symptoms involving respiratory system and chest Dysphagia Abdominal pain, unspecified site Abdominal pain, right upper quadrant Abdom pain l upper quad Abdominal pain periumbilic Abdominal pain, epigastric Abdominal pain, generalized Abdominal pain, other specified site Abdom/pelvic swelling unsp site Other ascites Oth abnormality red blood cells Elevated sedimentation rate Other abnormal glucose Other nonspecific abnormal serum enzyme levels Oth abnormal blood chemistry Bacteremia Abnormal arterial blood gases Elevated c-reactive protein Nonspecific abnormal findings on radiological and other examination of lung field Abnormal findings lung field other Unsp abnormal mammogram Mammographic microcalcification Ot abnormal radiolog exam breast Nonspecific abnormal results of pulmonary system function study Nonspecific abnormal unspecified cardiovascular function study Nonspecific abnormal electrocardiogram (ECG) (EKG) Other nonspecific abnormal cardiovascular system function study Nonspecific reaction tb test Other abnormal tumor markers Hypoxemia Symptoms involv emotional state Fracture cervical vert unsp cl Fracture c2 vertebra closed Fracture c3 vertebra closed Fracture c4 vertebra closed Fracture c5 vertebra closed 78630 78650 78651 78652 78659 7866 7869 7872 78900 78901 78902 78905 78906 78907 78909 78930 78959 79009 7901 79029 7905 7906 7907 79091 79095 7931 79319 79380 79381 79389 7942 79430 79431 79439 7955 79589 79902 7992 80500 80502 80503 80504 80505 90 Fracture c6 vertebra closed Fracture c7 vertebra closed Fracture mult cervical vert cl Fracture dorsal vertebra close Fracture lumbar vertebra close Vertebral fracture unsp closed C1-c4 fracture clos/cord inj unsp C5-c7 fracture clos/cord inj unsp Closed fracture two ribs Closed fracture multiple ribs uns Closed fracture uns part clavicle Fracture gr tuberos humerus closed Disloc shoulder unsp closed Traum subarachnoid hemorrage Traumatic subdural hemorrage Traumatic brain hemorrage ot Intracranial injury ot Traumatic pneumothorax wo open wd Lung contusion wo open wound Contusion face/scalp/nck Contusion of shoulder region Contusion of uns site C1-c4 inj w central cord syndrome Uns head injury Injury face/neck Other injury of abdomen Other injury other sites of trunk Oth/uns injury shoulder/upper arm Injury other sites inc mult sites Injury uns site Poisoning anticoagulants Other/unspec adverse effect drug Other adverse effect drug Sepsis Mechanical complication due to cardiac pacemaker (electrode) Mechanical complication due to coronary bypass graft Malfunction vasc device/graf Other complications due to other cardiac device, implant, and graft Complications of transplanted heart Complication lung transplant Cardiac complications Hematoma complication proced Accidental op laceration 80506 80507 80508 8052 8054 8058 80600 80605 80702 80709 81000 81203 83100 85200 85220 85300 85400 8600 86121 920 92300 9249 95203 95901 95909 95912 95919 9592 9598 9599 9642 9952 99529 99591 99601 99603 9961 99672 99683 99684 9971 99812 9982 91 Other postop infection Traffic acc nos-pers nos Acc cut/hem in surgery Abn react-surg proc nec Fall from slipping nec Fall nec Fall nos Accident nos Adv eff antineoplastic Adv eff antilipemics Contact/exposure to tb History malignancy bladder History other malignancy skin History tuberculosis Unspecified circulatory disease Personal history of other diseases of circulatory system History pneumonia Personal history of surgery to heart and great vessels, presenting hazards to health History exposure to asbestos History of fall Kidney replaced by transplant Heart replaced by transplant Heart valve replaced by transplant Lung replaced by transplant Heart valve replaced by other means Cardiac pacemaker in situ Automatic implantable cardiac defibrillator in situ Postprocedural aortocoronary bypass status Postprocedural percutaneous transluminal coronary angioplasty status Other cardiorespiratory problems Awaiting organ transplant status Fitting and adjustment of cardiac pacemaker Removal int fixation device Encounter for antineoplastic chemotherapy Aftercare following organ transplant Encounter for long-term (current) use of other medications Encounter for therapeutic drug monitoring Follow-up examination following completed treatment with high-risk medications, not elsewhere classified Observ suspected tb Observ following oth accident Observation for suspected cardiovascular disease Screening for pulmonary tb 99859 E8199 E8700 E8788 E8859 E8888 E8889 E9289 E9331 E9422 V011 V1051 V1083 V1201 V1250 V1259 V1261 V151 V1584 V1588 V420 V421 V422 V426 V433 V4501 V4502 V4581 V4582 V472 V4983 V5331 V5401 V5811 V5844 V5869 V5883 V6751 V712 V714 V717 V741 92 Screening mammogram ot Special screening mal neo ot Screening for defic anemia ot V7612 V7649 V781 ICD-9 Codes for Excluding Cardiovascular Stress Tests See advanced imaging criteria. ICD-9 Codes for Excluding Echocardiograms Echocardiograms were excluded from the analysis if the associated primary, secondary, tertiary, or quaternary diagnosis involved: (i) proximal fractures; (ii) pulmonary and chest conditions, including anything potentially resulting in chest pain (e.g., chest wall contusion); (iii) esophageal conditions (e.g., esophagitis and esophageal spasm), except those that are painless, mild, and chronic (e.g., esophageal stricture, Barrett’s esophagus, and reflux); (iv) cardiac conditions, including shortness of breath, edema, congestive heart failure and anatomic anomalies; (v) end stage renal disease and dialysis, along with all electrolyte abnormalities; (vi) infections, including sepsis, but not urinary tract infections or pneumonia; (vii) anemia and bleeding conditions, except microscopic hematuria; (viii) abdominal conditions (including abdominal pain), but not benign tumor of the colon; (ix) psychiatric conditions; (x) acute central nervous system conditions (e.g., cerebrovascular accident, delirium) and seizure or epilepsy conditions, but not chronic conditions (e.g., dementia), head ache, or migraine; (xi) drug toxicity and poisoning; (xii) transplants; (xiii) malignant hypertension; (xiv) cancers; (xv) conditions involving arterial and pulmonary emboli, but not peripheral deep vein thrombosis; (xvi) falls; (xvii) autoimmune conditions; or (xviii) pain in the anterior and posterior thorax and shoulder areas (eg. back pain), but not specific shoulder conditions such as “capsular adhesion of shoulder” and “osteoarthrosis of shoulder.” Label Pulmonary diseases other mycobact Streptococcal septicemia Unspecified staphylococcal septicemia Methicillin susceptible Staphylococcus aureus septicemia Methicillin resistant Staphylococcus aureus septicemia Other staphylococcal septicemia Pneumococcal septicemia Septicemia due to anaerobes Septicemia due to unspecified gram-negative organism Septicemia due to Escherichia coli (E. Coli) Septicemia due to pseudomonas Other septicemia due to gram-negative organism Other specified septicemia Unspecified septicemia Methicillin susceptible Staphylococcus aureus Methicillin resistant Staphylococcus aureus Code 0310 0380 03810 03811 03812 03819 0382 0383 03840 03842 03843 03849 0388 0389 04111 04112 93 Human immunodeficiency virus [HIV] Unspecified viral infection Lyme disease Candidal endocarditis Other and unspecified mycoses Sarcoidosis Unspecified infectious and parasitic diseases Malignant neoplasm of esophagus, unspecified site Malignant neoplasm of cardia Malignant neoplasm of stomach, unspecified site Malignant neoplasm of hepatic flexure Malignant neoplasm of transverse colon Malignant neoplasm of descending colon Malignant neoplasm of sigmoid colon Malignant neoplasm of cecum Malignant neoplasm of ascending colon Malignant neoplasm of colon, unspecified site Malignant neoplasm of rectosigmoid junction Malignant neoplasm of rectum Malignant neoplasm of liver, primary Malignant neoplasm of head of pancreas Malignant neoplasm of pancreas, part unspecified Malignant neoplasm of main bronchus Malignant neoplasm of upper lobe, bronchus, or lung Malignant neoplasm of middle lobe, bronchus, or lung Malignant neoplasm of lower lobe, bronchus, or lung Malignant neoplasm of other parts of bronchus or lung Malignant neoplasm of bronchus and lung, unspecified site Malignant neoplasm of heart Oth malig neo ear skin external Malig neo skin oth uns parts face Oth malignant neo scalp/skin neck Oth malig neo skin l limb inc hip Oth malignant neo skin site uns Malignant neoplasm of central portion of female breast Malignant neoplasm of upper-outer quadrant of female breast Malignant neoplasm of other specified sites of female breast Malignant neoplasm of breast (female), unspecified site Malignant neoplasm of corpus uteri, except isthmus Malignant neoplasm of ovary Malignant neoplasm of prostate Malignant neoplasm of other specified sites of bladder Malignant neoplasm of bladder, part unspecified 042 07999 08881 11281 1179 135 1369 1509 1510 1519 1530 1531 1532 1533 1534 1536 1539 1540 1541 1550 1570 1579 1622 1623 1624 1625 1628 1629 1641 1732 1733 1734 1737 1739 1741 1744 1748 1749 1820 1830 185 1888 1889 94 Malignant neoplasm of kidney, except pelvis Malignant neo thyroid gland Secondary malignant neoplasm of lung Secondary malignant neoplasm of pleura Secondary malignant neoplasm of retroperitoneum and peritoneum Secondary malignant neoplasm of liver Secondary malignant neoplasm of brain and spinal cord Secondary malignant neoplasm of bone and bone marrow Secondary malignant neoplasm of other specified sites Other malignant neoplasm of unspecified site Hodgkin's disease, unspecified type, unspecified site, extranodal and solid organ sites Nodular lymphoma, unspecified site, extranodal and solid organ sites Other malignant lymphomas, unspecified site, extranodal and solid organ sites Other malignant lymphomas of lymph nodes of head, face, and neck Other malignant lymphomas of intra-abdominal lymph nodes Other malignant lymphomas of lymph nodes of multiple sites Multiple myeloma, without mention of having achieved remission Acute lymphoid leukemia, without mention of having achieved remission Chronic lymphoid leukemia, without mention of having achieved remission Acute myeloid leukemia, without mention of having achieved remission Chronic myeloid leukemia, without mention of having achieved remission Unspecified leukemia, without mention of having achieved remission Benign neoplasm bronchus/lung Benign neoplasm of heart Benign neoplasm cerebral meninges Carcinoma in situ of bronchus and lung Carcinoma in situ of breast Ca in situ prostate Uncert behavior neo intestine Uncert behavior neo lung Uncert behavior neo prostate Uncert behavior neo bladder Uncert behavior neo kidney Uncert behavior neo skin Uncert behavior neo breast Polycythemia vera Essential thrombocythemia Lo gr myelodysplastic synd lesions Myelodysplastic syndrome, unspecified Neoplasm of uncertain behavior of other specified sites Neoplasm of uncertain behavior, site unspecified Neoplasm of unspecified nature of digestive system 1890 193 1970 1972 1976 1977 1983 1985 19889 1991 20190 20200 20280 20281 20283 20288 20300 20400 20410 20500 20510 20890 2123 2127 2252 2312 2330 2334 2352 2357 2365 2367 23691 2382 2383 2384 23871 23872 23875 2388 2389 2390 95 Neoplasm of unspecified nature of respiratory system Bone/skin unsp behavior neo Neoplasm of unspecified nature of breast Bladder unsp behavior neo Ot gu unsp behavior neo Neoplasm of unspecified nature of brain Endonerv unsp behavior neo Neoplasm of unspecified nature of other specified sites Neoplasms of unspecified nature, other specified sites Neoplasm of unspecified nature, site unspecified Acute thyroiditis Diabetes hypersmolarity type ii Glucocorticoid deficiency Carcinoid syndrome Uns protein calorie malnutrition Disturb sulphur amino acid metabol Monoclonal paraproteinemia Disorders of iron metabolism Disorders magnesium metabolism Disorders phosphorus metabolism Uns disorder calcium metabolism Hypocalcemia Hypercalcemia Oth disorders calcium metabolism Hyperosmolality/or hypernatremia Hyposmolality/or hyponatremia Acidosis Volume depletion, unspecified Dehydration Fluid overload Fluid overload nec (other fluid overload) Hyperpotassemia Hypopotassemia Electrolyte/fluid disorders oth Amyloidosis Amyloidosis, unspecified Other amyloidosis Autoimmune disease, not elsewhere classified Iron deficiency anemia blood loss Iron def anemia inadeq iron intake Other iron deficiency anemias Uns iron deficiency anemia Pernicious anemia 2391 2392 2393 2394 2395 2396 2397 2398 23989 2399 2450 25020 25541 2592 2639 2704 2731 2750 2752 2753 27540 27541 27542 27549 2760 2761 2762 27650 27651 2766 27669 2767 2768 2769 2773 27730 27739 2794 2800 2801 2808 2809 2810 96 Oth vitamin b12 deficiency anemia Folate deficiency anemia Other megaloblastic anemias oth Anemia w ot nutritional deficiency Uns deficiency anemia Sickle-cell disease, unspecified Hb-SS disease with crisis Uns acquired hemolytic anemia Pancytopenia Other aplastic anemias Sideroblastic anemia Anemia chronic kidney disease Anemia of other chronic disease Other specified anemias Anemia unspecified Defibrination syndrome Oth nonthrombocytopenic purpuras Primary thrombocytopenia unspec Immune thrombocytopenic purpura Uns thrombocytopenia Neutropenia unspecified Functional disord neutrophils Leukocytopenia unspecified Leukocytosis unspecified Other disease white blood cells Polycythemia secondary Ot dis blood/blood forming organs Uns dis blood/blood forming organs Drug-induced delirium Delirium due to conditions classified elsewhere Uns schizophrenia Depressive type psychosis Maj depress dis recurr epi uns Maj depress dis recur epi sev Bipolar i disorder unspecified Bipolar disorder unspecified Unspecified psychosis Anxiety state unspecified Panic disorder wo agoraphobia Generalized anxiety disorder Dysthymic disorder Psychosex dysfunc inhibited excite Oth/uns alcohol dependence uns 2811 2812 2813 2818 2819 28260 28262 2839 2841 2848 2850 28521 28529 2858 2859 2866 2872 28730 28731 2875 28800 2881 28850 28860 2888 2890 28989 2899 29281 2930 29590 29620 29630 29633 2967 29680 2989 30000 30001 30002 3004 30272 30390 97 Opioid type dependence uns Opioid type dependence continuous Unspec drug dependence uns Alcohol abuse unspec Oth mixed/uns drug abuse uns Adjustment disorder mixed Personality chg due to oth cond Depressive disorder other Obstructive hydrocephalus Carotid sinus syndrome Other acute postoperative pain Multiple sclerosis Encephalopathy, unspecified Metabolic encephalopathy Other encephalopathy Toxic encephalopathy Myasthenia gravis with (acute) exacerbation Hereditary progressive muscular dystrophy Unspecified retinal vascular occlusion Central artery occlusion of retina Arterial branch occlusion of retina Partial arterial occlusion of retina Transient arterial occlusion of retina Sudden visual loss Other visual disturbances Uns peripheral vertigo Benign paroxysmal position vertigo Rheumatic fever without mention of heart involvement Acute rheumatic pericarditis Acute rheumatic endocarditis Other acute rheumatic heart disease Unspecified acute rheumatic heart disease Chronic rheumatic pericarditis Mitral stenosis Rheumatic mitral insufficiency Mitral stenosis with insufficiency Other and unspecified mitral valve diseases Rheumatic aortic stenosis Rheumatic aortic insufficiency Rheumatic aortic stenosis with insufficiency Other and unspecified rheumatic aortic diseases Mitral valve stenosis and aortic valve stenosis Mitral valve stenosis and aortic valve insufficiency 30400 30401 30490 30500 30590 30928 3101 311 3314 33701 33818 340 34830 34831 34839 34982 35801 3591 36230 36231 36232 36233 36234 36811 3688 38610 38611 390 3910 3911 3918 3919 393 3940 3941 3942 3949 3950 3951 3952 3959 3960 3961 98 Mitral valve insufficiency and aortic valve stenosis Mitral valve insufficiency and aortic valve insufficiency Multiple involvement of mitral and aortic valves Unspecified mitral and aortic valve diseases Diseases of tricuspid valve Rheumatic diseases of pulmonary valve Rheumatic diseases of endocardium, valve unspecified Rheumatic myocarditis Unspecified rheumatic heart disease Rheumatic heart failure (congestive) Other and unspecified rheumatic heart diseases Malignant hypertensive heart disease without heart failure Malignant hypertensive heart disease with heart failure Benign hypertensive heart disease without heart failure Benign hypertensive heart disease with heart failure Hypertensive heart dis unspec Hypertensive heart disease, unspecified, with heart failure Mal kid hyper w ckd stage i-iv Hypertensive chronic kidney disease, benign, with chronic kidney disease stage IIV Hypertensive heart and chronic kidney disease, malignant, without heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, malignant, with heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, malignant, without heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, malignant, with heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, benign, without heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, benign, with heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, benign, without heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, benign, with heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, unspecified, without heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, unspecified, with heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, unspecified, without heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, unspecified, with heart failure and with chronic kidney disease stage V Secondary renovascular hypertension, malignant Secondary renovascular hypertension, benign 3962 3963 3968 3969 3970 3971 3979 3980 39890 39891 39899 40200 40201 40210 40211 40290 40291 40300 40310 40400 40401 40402 40403 40410 40411 40412 40413 40490 40491 40492 40493 40501 40511 99 Acute myocardial infarction of anterolateral wall, episode of care unspecified Acute myocardial infarction of anterolateral wall, initial episode of care Acute myocardial infarction of anterolateral wall, subsequent episode of care Acute myocardial infarction of other anterior wall, episode of care unspecified Acute myocardial infarction of other anterior wall, initial episode of care Acute myocardial infarction of other anterior wall, subsequent episode of care Acute myocardial infarction of inferolateral wall, episode of care unspecified Acute myocardial infarction of inferolateral wall, initial episode of care Acute myocardial infarction of inferolateral wall, subsequent episode of care Acute myocardial infarction of inferoposterior wall, episode of care unspecified Acute myocardial infarction of inferoposterior wall, initial episode of care Acute myocardial infarction of inferoposterior wall, subsequent episode of care Acute myocardial infarction of other inferior wall, episode of care unspecified Acute myocardial infarction of other inferior wall, initial episode of care Acute myocardial infarction of other inferior wall, subsequent episode of care Acute myocardial infarction of other lateral wall, episode of care unspecified Acute myocardial infarction of other lateral wall, initial episode of care Acute myocardial infarction of other lateral wall, subsequent episode of care Acute myocardial infarction, true posterior wall infarction, episode of care unspecified Acute myocardial infarction, true posterior wall infarction, initial episode of care Acute myocardial infarction, true posterior wall infarction, subsequent episode of care Acute myocardial infarction, subendocardial infarction, episode of care unspecified Acute myocardial infarction, subendocardial infarction, initial episode of care Acute myocardial infarction, subendocardial infarction, subsequent episode of care Acute myocardial infarction of other specified sites, episode of care unspecified Acute myocardial infarction of other specified sites, initial episode of care Acute myocardial infarction of other specified sites, subsequent episode of care Acute myocardial infarction, unspecified site, episode of care unspecified Acute myocardial infarction, unspecified site, initial episode of care Acute myocardial infarction, unspecified site, subsequent episode of care Postmyocardial infarction syndrome Intermediate coronary syndrome Acute coronary occlusion without myocardial infarction Other acute and subacute form of ischemic heart disease Old myocardial infarction Angina decubitus Prinzmetal angina Other and unspecified angina pectoris Coronary atherosclerosis of unspecified type of vessel, native or graft Coronary atherosclerosis of native coronary artery 41000 41001 41002 41010 41011 41012 41020 41021 41022 41030 41031 41032 41040 41041 41042 41050 41051 41052 41060 41061 41062 41070 41071 41072 41080 41081 41082 41090 41091 41092 4110 4111 41181 41189 412 4130 4131 4139 41400 41401 100 Coronary atherosclerosis of autologous vein bypass graft Coronary atherosclerosis of nonautologous biological bypass graft Coronary atherosclerosis of artery bypass graft Coronary atherosclerosis of unspecified type of bypass graft Coronary atherosclerosis, of native coronary artery of transplanted heart Coronary atherosclerosis, of bypass graft (artery) (vein) of transplanted heart Aneurysm of heart Aneurysm of coronary vessels Dissection of coronary artery Other aneurysm of heart Chronic total occlusion of coronary artery Coronary atherosclerosis due to lipid rich plaque Other specified forms of chronic ischemic heart disease Unspecified chronic ischemic heart disease Acute cor pulmonale Iatrogenic pulmonary embolism and infarction Septic pulmonary embolism Other pulmonary embolism and infarction Primary pulmonary hypertension Kyphoscoliotic heart disease Chronic pulmonary embolism Other chronic pulmonary heart diseases Unspecified chronic pulmonary heart disease Arteriovenous fistula of pulmonary vessels Aneurysm of pulmonary artery Other specified disease of pulmonary circulation Unspecified disease of pulmonary circulation Acute pericarditis in diseases classified elsewhere Unspecified acute pericarditis Acute idiopathic pericarditis Other acute pericarditis Acute and subacute bacterial endocarditis Acute and subacute infective endocarditis in diseases classified elsewhere Unspecified acute endocarditis Acute myocarditis in diseases classified elsewhere Unspecified acute myocarditis Idiopathic myocarditis Septic myocarditis Toxic myocarditis Hemopericardium Adhesive pericarditis Constrictive pericarditis Cardiac tamponade 41402 41403 41404 41405 41406 41407 41410 41411 41412 41419 4142 4143 4148 4149 4150 41511 41512 41519 4160 4161 4162 4168 4169 4170 4171 4178 4179 4200 42090 42091 42099 4210 4211 4219 4220 42290 42291 42292 42293 4230 4231 4232 4233 101 Other specified diseases of pericardium Unspecified disease of pericardium Mitral valve disorders Aortic valve disorders Tricuspid valve disorders, specified as nonrheumatic Pulmonary valve disorders Endocarditis, valve unspecified, unspecified cause Endocarditis in diseases classified elsewhere Other endocarditis, valve unspecified Endomyocardial fibrosis Hypertrophic obstructive cardiomyopathy Hypertrophic obstructive cardiomyopathy Other hypertrophic cardiomyopathy Obscure cardiomyopathy of Africa Endocardial fibroelastosis Other primary cardiomyopathies Alcoholic cardiomyopathy Nutritional and metabolic cardiomyopathy Cardiomyopathy in other diseases classified elsewhere Unspecified secondary cardiomyopathy Atrioventricular block, complete Unspecified atrioventricular block First degree atrioventricular block Mobitz (type) II atrioventricular block Other second degree atrioventricular block Left bundle branch hemiblock Other left bundle branch block Right bundle branch block Unspecified bundle branch block Right bundle branch block and left posterior fascicular block Right bundle branch block and left anterior fascicular block Other bilateral bundle branch block Trifascicular block Other heart block Anomalous atrioventricular excitation Long QT syndrome Other specified conduction disorder Unspecified conduction disorder Paroxysmal supraventricular tachycardia Paroxysmal ventricular tachycardia Unspecified paroxysmal tachycardia Atrial fibrillation Atrial flutter 4238 4239 4240 4241 4242 4243 42490 42491 42499 4250 4251 42511 42518 4252 4253 4254 4255 4257 4258 4259 4260 42610 42611 42612 42613 4262 4263 4264 42650 42651 42652 42653 42654 4266 4267 42682 42689 4269 4270 4271 4272 42731 42732 102 Ventricular fibrillation Ventricular flutter Cardiac arrest Unspecified premature beats Supraventricular premature beats Other premature beats Sinoatrial node dysfunction Other specified cardiac dysrhythmias Unspecified cardiac dysrhythmia Congestive heart failure, unspecified Left heart failure Unspecified systolic heart failure Acute systolic heart failure Chronic systolic heart failure Acute on chronic systolic heart failure Unspecified diastolic heart failure Acute diastolic heart failure Chronic diastolic heart failure Acute on chronic diastolic heart failure Unspecified combined systolic and diastolic heart failure Acute combined systolic and diastolic heart failure Chronic combined systolic and diastolic heart failure Acute on chronic combined systolic and diastolic heart failure Unspecified heart failure Unspecified myocarditis Myocardial degeneration Unspecified cardiovascular disease Cardiomegaly Functional disturbances following cardiac surgery Rupture of chordae tendineae Rupture of papillary muscle Acquired cardiac septal defect Other certain sequelae of myocardial infarction, not elsewhere classified Other disorders of papillary muscle Hyperkinetic heart disease Takotsubo syndrome Other ill-defined heart disease Unspecified heart disease Subarachnoid hemorrhage Intracerebral hemorrhage Subdural hemorrhage Unspecified intracranial hemorrhage Occlusion and stenosis of basilar artery without mention of cerebral infarction 42741 42742 4275 42760 42761 42769 42781 42789 4279 4280 4281 42820 42821 42822 42823 42830 42831 42832 42833 42840 42841 42842 42843 4289 4290 4291 4292 4293 4294 4295 4296 42971 42979 42981 42982 42983 42989 4299 430 431 4321 4329 43300 103 Occlusion and stenosis of basilar artery with cerebral infarction Occlusion and stenosis of carotid artery without mention of cerebral infarction Occlusion and stenosis of carotid artery with cerebral infarction Occlusion vertebral artery wo infar Occlusion and stenosis of multiple and bilateral precerebral arteries without mention of cerebral infarction Occlusion and stenosis of multiple and bilateral precerebral arteries with cerebral infarction Occlusion and stenosis of unspecified precerebral artery without mention of cerebral infarction Occlusion and stenosis of unspecified precerebral artery with cerebral infarction Cerebral thrombosis without mention of cerebral infarction Cerebral thrombosis with cerebral infarction Cerebral embolism without mention of cerebral infarction Cerebral embolism with cerebral infarction Unspecified cerebral artery occlusion without mention of cerebral infarction Unspecified cerebral artery occlusion with cerebral infarction Basilar artery syndrome Vertebral artery syndrome Subclavian steal syndrome Vertebrobasilar artery syndrome Other specified transient cerebral ischemias Unspecified transient cerebral ischemia Acute, but ill-defined, cerebrovascular disease Other generalized ischemic cerebrovascular disease Hypertensive encephalopathy Cerebral aneurysm nonruptured Transient global amnesia Unspecified cerebrovascular disease Hemiplegia affecting unspecified side due to cerebrovascular disease Vertigo Uns late effects cv disease Atherosclerosis of aorta Atherosclerosis of native arteries of the extremities, unspecified Atherosclerosis of native arteries of the extremities with intermittent claudication Atherosclerosis of native arteries of the extremities with rest pain Atherosclerosis of native arteries of the extremities with ulceration Atherosclerosis of native arteries of the extremities with gangrene Other atherosclerosis of native arteries of the extremities Generalized and unspecified atherosclerosis Dissecting aortic aneurysm (any part), unspecified site Dissecting aortic aneurysm (any part), thoracic Dissecting aortic aneurysm (any part), abdominal Dissecting aortic aneurysm (any part), thoracoabdominal 43301 43310 43311 43320 43330 43331 43390 43391 43400 43401 43410 43411 43490 43491 4350 4351 4352 4353 4358 4359 436 4371 4372 4373 4377 4379 43820 43885 4389 4400 44020 44021 44022 44023 44024 44029 4409 44100 44101 44102 44103 104 Thoracic aneurysm, ruptured Thoracic aneurysm without mention of rupture Abdominal aneurysm, ruptured Abdominal aneurysm without mention of rupture Aortic aneurysm of unspecified site, ruptured Thoracoabdominal aneurysm, ruptured Thoracoabdominal aneurysm without mention of rupture Aortic aneurysm of unspecified site without mention of rupture Aneurysm of iliac artery Aneurysm of artery of lower extremity Aneurysm of artery of neck Other aneurysm of unspecified site Raynaud's syndrome Thromboangiitis obliterans (Buerger's disease) Peripheral angiopathy in diseases classified elsewhere Embolism and thrombosis of abdominal aorta Embolism and thrombosis of thoracic aorta Embolism and thrombosis of arteries of upper extremity Embolism and thrombosis of arteries of lower extremity Embolism and thrombosis of iliac artery Embolism and thrombosis of other specified artery Embolism and thrombosis of unspecified artery Atheroembolism of other site Wegener's granulomatosis Giant cell arteritis Takayasu's disease Stricture of artery Unspecified arteritis Aortic ectasia unspecified site Thoracic aortic ectasia Other specified disorders of arteries and arterioles Unspecified disorders of arteries and arterioles Embolism and thrombosis of vena cava Venous embolism and thrombosis of unspecified deep vessels of lower extremity Venous embolism and thrombosis of deep vessels of proximal lower extremity Venous embolism and thrombosis of deep vessels of distal lower extremity Venous embolism and thrombosis of other specified veins Embolism and thrombosis of unspecified site Orthostatic hypotension Chronic hypotension Hypotension of hemodialysis Other iatrogenic hypotension Other specified hypotension 4411 4412 4413 4414 4415 4416 4417 4419 4422 4423 44281 4429 4430 4431 44381 4440 4441 44421 44422 44481 44489 4449 44589 4464 4465 4467 4471 4476 44770 44771 4478 4479 4532 45340 45341 45342 4538 4539 4580 4581 45821 45829 4588 105 Unspecified hypotension Hemorrhage unspecified Other specified circulatory system disorders Unspecified circulatory system disorder Acute upper resp infect oth sites Acute upper respiratory infections of unspecified site Acute bronchitis Pneumonia adenovirus Pneumonia respiratory syncy virus Uns viral pneumonia Pneumococcal pneumonia Methicillin susceptible pneumonia due to Staphylococcus aureus Pneumonia other bacteria Uns bacterial pneumonia Bronchopneumonia organism unspec Pneumonia organism unspecified Influenza with pneumonia Influenza w oth respiratory manif Obstructive chronic bronchitis, with (acute) exacerbation Obstructive chronic bronchitis with acute bronchitis Extrinsic asthma, unspecified Ex asthma w exacerbation Intrinsic asthma, unspecified Chronic obstructive asthma, unspecified Chronic obstructive asthma with status asthmaticus Chronic obstructive asthma, with (acute) exacerbation Asthma, unspecified, unspecified status Asthma, unspecified with status asthmaticus Asthma, unspecified, with (acute) exacerbation Bronchiectasis with acute exacerbation Chronic airway obstruction, not elsewhere classified Pneumonitis inhalation food Empyema without mention of fistula Pleurisy without mention of effusion or current tuberculosis Pleurisy with effusion, with mention of bacterial cause other than tuberculosis Other specified forms of pleural effusion, except tuberculous Malignant pleural effusion Other specified forms of effusion, except tuberculous Unspecified pleural effusion Other spontaneous pneumothorax Abscess of lung Pulmonary congestion and hypostasis Postinflammatory pulmonary fibrosis 4589 4590 45989 4599 4658 4659 4660 4800 4801 4809 481 48241 48289 4829 485 486 4870 4871 49121 49122 49300 49302 49310 49320 49321 49322 49390 49391 49392 4941 496 5070 5109 5110 5111 5118 51181 51189 5119 5128 5130 514 515 106 Idiopathic fibrosing alveolitis Other specified alveolar and parietoalveolar pneumonopathies Uns alveolar pneumonopathy Pulmonary collapse Unspecified acute edema of lung Pulmonary insufficiency following trauma and surgery Acute respiratory failure Other pulmonary insufficiency, not elsewhere classified Chronic respiratory failure Acute and chronic respiratory failure Other diseases of lung, not elsewhere classified Acute bronchospasm Oth diseases trachea/bronchus Disorders diaphragm Oth diseases respiratory system Unspecified disease of respiratory system Uns esophagitis Reflux esophagitis Oth esophagitis Acute gastritis wohemorrhage Uns ulcerative colitis Acute vascular insufficiency of intestine Unspecified vascular insufficiency of intestine Diverticulosis of colon with hemorrhage Hemoperitoneum (nontraumatic) Hepatic coma Acute pancreatitis Hematemesis Celiac disease Acute renal failure with lesion of tubular necrosis Unspecified acute renal failure End stage renal disease Diffuse cystic mastopathy Mastodynia Lump or mass in breast Oth signs/symptoms in breast Postmenopausal bleeding Suspected damage to fetus from drugs, affecting management of mother, antepartum condition or complication Other known or suspected fetal abnormality, not elsewhere classified, affecting management of mother, antepartum condition or complication Unspecified fetal abnormality affecting management of mother, antepartum condition or complication Lupus erythematosus 5163 5168 5169 5180 5184 5185 51881 51882 51883 51884 51889 51911 51919 5194 5198 5199 53010 53011 53019 53500 5569 5570 5579 56212 56881 5722 5770 5780 5790 5845 5849 5856 6101 61171 61172 61179 6271 65553 65583 65593 6954 107 Psoriatic arthropathy Oth psoriasis Systemic lupus erythematosus Systemic sclerosis Sicca syndrome Uns diffuse connect tissue disease Pyogenic arthritis shoulder Rheumatoid arthritis Rheumatoid arthritis visceral/syst Uns inflammatory polyarthropathy Uns polyarthrit/arthropth site uns Effusion of joint shoulder Effusion of lower leg joint Degenerat thoracic iv disc Oth syndromes affecting cervical Pain in thoracic spine Uns thoracic/lumb neuritis/radicul Backache unspecified Oth symptoms referable to back Polymyalgia rheumatica Oth affections shoulder region Muscle weakness Rhabdomyolysis Rheumatism uns/fibrositis Uns myalgia/myositis Swelling of limb Acute osteomyelitis oth sites Uns osteomyelitis site uns Uns osteomyelitis oth sites Pathological fracture vertebrae Tietze's disease Kyphosis Scoliosis oth conditions Acquired deformity chest/rib Oth acquired deformity back/spine Bulbus cordis anomalies and anomalies of cardiac septal closure, common truncus Complete transposition of great vessels Transposition of great vessels, double outlet right ventricle Corrected transposition of great vessels Other transposition of great vessels Tetralogy of Fallot Bulbus cordis anomalies and anomalies of cardiac septal closure, common ventricle 6960 6961 7100 7101 7102 7109 71101 7140 7142 7149 71650 71901 71906 72251 7238 7241 7244 7245 7248 725 7262 72887 72888 7290 7291 72981 73008 73020 73028 73313 7336 73710 73743 7383 7385 7450 74510 74511 74512 74519 7452 7453 108 Ventricular septal defect Ostium secundum type atrial septal defect Unspecified type congenital endocardial cushion defect Ostium primum defect Other congenital endocardial cushion defect Other bulbus cordis anomalies and anomalies of cardiac septal closure Unspecified congenital defect of septal closure Unspecified congenital pulmonary valve anomaly Congenital atresia of pulmonary valve Congenital stenosis of pulmonary valve Other congenital anomalies of pulmonary valve Congenital tricuspid atresia and stenosis Ebstein's anomaly Congenital stenosis of aortic valve Congenital insufficiency of aortic valve Congenital mitral stenosis Congenital mitral insufficiency Hypoplastic left heart syndrome Congenital subaortic stenosis Congenital obstructive anomalies of heart, not elsewhere classified Congenital coronary artery anomaly Congenital heart block Congenital malposition of heart and cardiac apex Other specified congenital anomaly of heart Unspecified congenital anomaly of heart Patent ductus arteriosus Coarctation of aorta (preductal) (postductal) Unspecified congenital anomaly of aorta Congenital anomaly of aortic arch Congenital atresia and stenosis of aorta Other congenital anomaly of aorta Congenital anomalies of pulmonary artery Partial congenital anomalous pulmonary venous connection Uns anomaly lung Anomalies diaphragm Down's syndrome Marfan's syndrome Other specified multiple congenital anomalies, so described Coma Transient alteration of awareness Other alteration of consciousness Syncope and collapse Dizziness and giddiness 7454 7455 74560 74561 74569 7458 7459 74600 74601 74602 74609 7461 7462 7463 7464 7465 7466 7467 74681 74684 74685 74686 74687 74689 7469 7470 74710 74720 74721 74722 74729 7473 74742 74860 7566 7580 75982 75989 78001 78002 78009 7802 7804 109 Fever and other physiologic disturbances of temperature regulation Fever, unspecified Fever presenting with conditions classified elsewhere Chronic fatigue syndrome Other malaise and fatigue Memory loss Altered mental status Localized superficial swelling Edema Cyanosis Spontaneous ecchymoses Loss of weight Headache Swelling/mass/lump in head/neck Epistaxis Unspecified tachycardia Palpitations Undiagnosed cardiac murmurs Other abnormal heart sounds Gangrene Unspecified shock Cardiogenic shock Septic shock Other shock without mention of trauma Enlargement of lymph nodes Other symptoms involving cardiovascular system Unspecified respiratory abnormality Hyperventilation Orthopnea Apnea Cheyne-Stokes respiration Shortness of breath Tachypnea Wheezing Other dyspnea and respiratory abnormalities Cough Hemoptysis Hemoptysis unspecified Chest pain, unspecified Precordial pain Painful respiration Chest pain, other Swelling/mass/lump in chest 7806 78060 78061 78071 78079 78093 78097 7822 7823 7825 7827 78321 7840 7842 7847 7850 7851 7852 7853 7854 78550 78551 78552 78559 7856 7859 78600 78601 78602 78603 78604 78605 78606 78607 78609 7862 7863 78630 78650 78651 78652 78659 7866 110 Abnormal chest sounds Other symptoms involving respiratory system and chest Dysphagia Abdominal pain uns site Abdom pain l upper quad Abdominal pain periumbilic Abdominal pain generalized Abdom/pelvic swelling unsp site Other ascites Oth abnormality red blood cells Elevated sedimentation rate Other abnormal glucose Oth abnormal blood chemistry Bacteremia Abnormal arterial blood gases Elevated c-reactive protein Abnormal findings lung field Abnormal findings lung field other Nonspecific abnormal findings on radiological and other examination of other intrathoracic organs Nonspecific abnormal findings on radiological and other examination of abdominal area, including retroperitoneum Unsp abnormal mammogram Mammographic microcalcification Ot abnormal radiolog exam breast Abnormal pulmonary func study Nonspecific abnormal unspecified cardiovascular function study Nonspecific abnormal electrocardiogram (ECG) (EKG) Other nonspecific abnormal cardiovascular system function study Nonspecific abnormal findings on chromosomal analysis Nonspecific reaction tb test Other abnormal tumor markers Nonspecific low blood pressure reading Asphyxia Hypoxemia Respiratory arrest Symptoms involv emotional state Fracture cervical vert unsp cl Fracture c2 vertebra closed Fracture c3 vertebra closed Fracture c4 vertebra closed Fracture c5 vertebra closed Fracture c6 vertebra closed Fracture c7 vertebra closed 7867 7869 7872 78900 78902 78905 78907 78930 78959 79009 7901 79029 7906 7907 79091 79095 7931 79319 7932 7936 79380 79381 79389 7942 79430 79431 79439 7952 7955 79589 7963 79901 79902 7991 7992 80500 80502 80503 80504 80505 80506 80507 111 Fracture mult cervical vert cl Fracture dorsal vertebra close Fracture lumbar vertebra close Vertebral fracture unsp closed C1-c4 fracture clos/cord inj unsp C5-c7 fracture clos/cord inj unsp Closed fracture of rib(s), unspecified Closed fracture of one rib Closed fracture of two ribs Closed fracture of three ribs Closed fracture of multiple ribs, unspecified Closed fracture of sternum Flail chest Closed fracture uns part clavicle Fracture gr tuberos humerus closed Disloc shoulder unsp closed Subarachnoid hemorrhage following injury, without mention of open intracranial wound, unspecified state of consciousness Subarachnoid hemorrhage following injury, without mention of open intracranial wound, no loss of consciousness Traumatic subdural hemorrage Subdural hemorrhage following injury, without mention of open intracranial wound, with brief [less than one hour] loss of consciousness Subdural hemorrhage following injury, without mention of open intracranial wound, loss of consciousness of unspecified duration Other and unspecified intracranial hemorrhage following injury, without mention of open intracranial wound, unspecified state of consciousness Intracranial injury ot Traumatic pneumothorax without mention of open wound into thorax Traumatic hemothorax without mention of open wound into thorax Unspecified injury to heart without mention of open wound into thorax Heart contusion without mention of open wound into thorax Lung contusion wo open wound Contusion face/scalp/nck Contusion of chest wall Contusion of shoulder region Contusion of uns site C1-c4 inj w central cord syndrome Traumatic shock Uns head injury Injury face/neck Other injury of chest wall Other injury of abdomen Other injury other sites of trunk 80508 8052 8054 8058 80600 80605 80700 80701 80702 80703 80709 8072 8074 81000 81203 83100 85200 85201 85220 85222 85226 85300 85400 8600 8602 86100 86101 86121 920 9221 92300 9249 95203 9584 95901 95909 95911 95912 95919 112 Oth/uns injury shoulder/upper arm Injury other sites inc mult sites Injury uns site Poisoning by antineoplastic antibiotics Poisoning by antineoplastic and immunosuppressive drugs Poisoning by anticoagulants Poisoning by opium (alkaloids), unspecified Poisoning by opiates and related narcotics, other Poisoning by benzodiazepine-based tranquilizers Poisoning by cardiotonic glycosides and drugs of similar action Poisoning by unspecified drug or medicinal substance Effects of radiation, unspecified Angioneurotic edema not elsewhere classified Other and unspecified adverse effect of drug, medicinal and biological substance Unspecified adverse effect of unspecified drug, medicinal and biological substance Unspecified adverse effect of other drug, medicinal and biological substance Sepsis Severe sepsis Mechanical complication of unspecified cardiac device, implant, and graft Mechanical complication due to cardiac pacemaker (electrode) Mechanical complication due to heart valve prosthesis Mechanical complication due to coronary bypass graft Mechanical complication due to automatic implantable cardiac defibrillator Mechanical complication of cardiac device, implant, and graft, other Mechanical complication of other vascular device, implant, and graft Infection and inflammatory reaction due to cardiac device, implant, and graft Infection and inflammatory reaction due to other vascular device, implant, and graft Infection and inflammatory reaction due to peritoneal dialysis catheter Other complications due to heart valve prosthesis Other complications due to other cardiac device, implant, and graft Other complications due to renal dialysis device, implant, and graft Other complications due to other vascular device, implant, and graft Complications of transplanted kidney Complications of transplanted heart Complications of transplanted lung Cardiac complications Respiratory complications Postoperative shock, not elsewhere classified Hematoma complication proced Accidental puncture or laceration during procedure Other postop infection Traffic acc nos-pers nos 9592 9598 9599 9607 9631 9642 96500 96509 9694 9721 9779 990 9951 9952 99520 99529 99591 99592 99600 99601 99602 99603 99604 99609 9961 99661 99662 99668 99671 99672 99673 99674 99681 99683 99684 9971 9973 9980 99812 9982 99859 E8199 113 Acc cut/hem in surgery Abn react-surg proc nec Fall from slipping nec Fall nec Fall nos Accident nos Antineoplastic and immunosuppressive drugs causing adverse effect in therapeutic use Adv eff antilipemics Contact/exposure to tb Personal history of malignant neoplasm of breast History malignancy bladder History other malignancy skin History tuberculosis Personal history of venous thrombosis and embolism Personal history of transient ischemic attack [TIA], and cerebral infarction without residual deficits Personal history of other diseases of circulatory system History pneumonia Personal history of surgery to heart and great vessels, presenting hazards to health History exposure to asbestos History of fall Family history of other cardiovascular diseases Kidney replaced by transplant Heart replaced by transplant Heart valve replaced by transplant Lung replaced by transplant Organ or tissue replaced by other means, Heart assist device Heart valve replaced by other means Blood vessel replaced by other means Unspecified cardiac device in situ Cardiac pacemaker in situ Automatic implantable cardiac defibrillator in situ Other specified cardiac device in situ Postprocedural aortocoronary bypass status Postprocedural percutaneous transluminal coronary angioplasty status Other cardiorespiratory problems Fitting and adjustment of cardiac pacemaker Fitting and adjustment of automatic implantable cardiac defibrillator Removal int fixation device Encounter for antineoplastic chemotherapy Encounter for antineoplastic immunotherapy Aftercare following organ transplant Encounter for long-term (current) use of other medications E8700 E8788 E8859 E8888 E8889 E9289 E9331 E9422 V011 V103 V1051 V1083 V1201 V1251 V1254 V1259 V1261 V151 V1584 V1588 V1749 V420 V421 V422 V426 V4321 V433 V434 V4500 V4501 V4502 V4509 V4581 V4582 V472 V5331 V5332 V5401 V5811 V5812 V5844 V5869 114 Encounter for therapeutic drug monitoring Chemotherapy follow-up examination Follow-up examination following completed treatment with high-risk medications, not elsewhere classified Observ suspected tb Observ following oth accident Observation for suspected cardiovascular disease Screening for pulmonary tb Screening mammogram ot Special screening mal neo ot Screening for defic anemia ot V5883 V672 V6751 V712 V714 V717 V741 V7612 V7649 V781 ICD-9 Codes for Excluding Electrocardiograms Electrocardiograms were excluded from the analysis if the associated primary, secondary, tertiary, or quaternary diagnosis involved: (i) proximal fractures; (ii) pulmonary and chest conditions, including anything potentially resulting in chest pain (e.g., chest wall contusion); (iii) esophageal conditions (e.g., esophagitis and esophageal spasm), except those that are painless, mild, and chronic (e.g., esophageal stricture, Barrett’s esophagus, and reflux); (iv) cardiac conditions, including shortness of breath, edema, congestive heart failure and anatomic anomalies; (v) end stage renal disease and dialysis, along with all electrolyte abnormalities; (vi) infections, including sepsis, but not urinary tract infections or pneumonia; (vii) anemia and bleeding conditions, except microscopic hematuria; (viii) abdominal conditions (including abdominal pain), but not benign tumor of the colon; (ix) psychiatric conditions; (x) acute central nervous system conditions (e.g., cerebrovascular accident, delirium) and seizure or epilepsy conditions, but not chronic conditions (e.g., dementia), head ache, or migraine; (xi) drug toxicity and poisoning; (xii) transplants; (xiii) malignant hypertension; (xiv) cancers; (xv) conditions involving arterial and pulmonary emboli, but not peripheral deep vein thrombosis; (xvi) falls; (xvii) autoimmune conditions; or (xviii) pain in the anterior and posterior thorax and shoulder areas (eg. back pain), but not specific shoulder conditions such as “capsular adhesion of shoulder” and “osteoarthrosis of shoulder.” Label Salmonella septicemia Unspecified food poisoning Pulmonary diseases other mycobact Disseminated diseases due to other mycobacteria Streptococcal septicemia Unspecified staphylococcal septicemia Methicillin susceptible Staphylococcus aureus septicemia Methicillin resistant Staphylococcus aureus septicemia Other staphylococcal septicemia Pneumococcal septicemia Septicemia due to anaerobes Septicemia due to unspecified gram-negative organism Code 0031 0059 0310 0312 0380 03810 03811 03812 03819 0382 0383 03840 115 Septicemia due to hemophilus influenzae (H. Influenzae) Septicemia due to Escherichia coli (E. Coli) Septicemia due to pseudomonas Septicemia due to serratia Other septicemia due to gram-negative organism Other specified septicemia Unspecified septicemia Gas gangrene Mssa infection Mrsa infection Human immunodeficiency virus [HIV] Unspecified viral meningitis Unspecified non-arthropod-borne viral disease of central nervous system Herpetic meningoencephalitis West Nile fever with encephalitis Chronic hepatitis C with hepatic coma Unspecified viral infection Lyme disease Syphilitic endocarditis, aortic valve Candidiasis of lung Disseminated candidiasis Candidiasis of the esophagus Aspergillosis Sarcoidosis Malignant neoplasm of lower lip, vermilion border Malignant neoplasm of base of tongue Malignant neoplasm of anterior two-thirds of tongue, part unspecified Malignant neoplasm of tongue, unspecified site Malignant neoplasm of parotid gland Malignant neoplasm of floor of mouth, part unspecified Malignant neoplasm of mouth, unspecified site Malignant neoplasm of tonsil Malignant neoplasm of oropharynx, unspecified site Malignant neoplasm of nasopharynx, unspecified site Malignant neoplasm of thoracic esophagus Malignant neoplasm of upper third of esophagus Malignant neoplasm of middle third of esophagus Malignant neoplasm of lower third of esophagus Malignant neoplasm of other specified part of esophagus Malignant neoplasm of esophagus, unspecified site Malignant neoplasm of cardia Malignant neoplasm of pylorus Malignant neoplasm of pyloric antrum 03841 03842 03843 03844 03849 0388 0389 0400 04111 04112 042 0479 0499 0543 06641 07044 07999 08881 09322 1124 1125 11284 1173 135 1401 1410 1414 1419 1420 1449 1459 1460 1469 1479 1501 1503 1504 1505 1508 1509 1510 1511 1512 116 Malignant neoplasm of fundus of stomach Malignant neoplasm of body of stomach Malignant neoplasm of lesser curvature of stomach, unspecified Malignant neoplasm of other specified sites of stomach Malignant neoplasm of stomach, unspecified site Malignant neoplasm of duodenum Malignant neoplasm of ileum Malignant neoplasm of small intestine, unspecified site Malignant neoplasm of hepatic flexure Malignant neoplasm of transverse colon Malignant neoplasm of descending colon Malignant neoplasm of sigmoid colon Malignant neoplasm of cecum Malignant neoplasm of appendix Malignant neoplasm of ascending colon Malignant neoplasm of splenic flexure Malignant neoplasm of other specified sites of large intestine Malignant neoplasm of colon, unspecified site Malignant neoplasm of rectosigmoid junction Malignant neoplasm of rectum Malignant neoplasm of anal canal Malignant neoplasm of anus, unspecified site Malignant neoplasm of other sites of rectum, rectosigmoid junction, and anus Malignant neoplasm of liver, primary Malignant neoplasm of intrahepatic bile ducts Malignant neoplasm of liver, not specified as primary or secondary Malignant neoplasm of gallbladder Malignant neoplasm of extrahepatic bile ducts Malignant neoplasm of ampulla of Vater Malignant neoplasm of biliary tract, part unspecified site Malignant neoplasm of head of pancreas Malignant neoplasm of body of pancreas Malignant neoplasm of tail of pancreas Malignant neoplasm of other specified sites of pancreas Malignant neoplasm of pancreas, part unspecified Malignant neoplasm of retroperitoneum Malignant neoplasm of specified parts of peritoneum Malignant neoplasm of peritoneum, unspecified Malignant neoplasm of intestinal tract, part unspecified Malignant neoplasm of nasal cavities Malignant neoplasm of maxillary sinus Malignant neoplasm of glottis Malignant neoplasm of supraglottis 1513 1514 1515 1518 1519 1520 1522 1529 1530 1531 1532 1533 1534 1535 1536 1537 1538 1539 1540 1541 1542 1543 1548 1550 1551 1552 1560 1561 1562 1569 1570 1571 1572 1578 1579 1580 1588 1589 1590 1600 1602 1610 1611 117 Malignant neoplasm of other specified sites of larynx Malignant neoplasm of larynx, unspecified site Malignant neoplasm of trachea Malignant neoplasm of main bronchus Malignant neoplasm of upper lobe, bronchus, or lung Malignant neoplasm of middle lobe, bronchus, or lung Malignant neoplasm of lower lobe, bronchus, or lung Malignant neoplasm of other parts of bronchus or lung Malignant neoplasm of bronchus and lung, unspecified site Malignant neoplasm of other specified sites of pleura Malignant neoplasm of pleura, unspecified site Malignant neoplasm of thymus Malignant neoplasm of heart Malignant neoplasm of mediastinum, part unspecified Malignant neoplasm of bone and articular cartilage, site unspecified Malignant neoplasm of connective and other soft tissue of head, face, and neck Malignant neoplasm of connective and other soft tissue of upper limb, including shoulder Malignant neoplasm of connective and other soft tissue of lower limb, including hip Malignant neoplasm of connective and other soft tissue of thorax Malignant neoplasm of connective and other soft tissue of abdomen Malignant neoplasm of connective and other soft tissue, site unspecified Malignant melanoma of skin of ear and external auditory canal Malignant melanoma of skin of other and unspecified parts of face Malignant melanoma of skin of scalp and neck Malignant melanoma of skin of trunk, except scrotum Malignant melanoma of skin of upper limb, including shoulder Malignant melanoma of skin of lower limb, including hip Malignant melanoma of other specified sites of skin Melanoma of skin, site unspecified Other malignant neoplasm of skin of lip Other malignant neoplasm of skin of eyelid, including canthus Other malignant neoplasm of skin of ear and external auditory canal Other malignant neoplasm of skin of other and unspecified parts of face Other malignant neoplasm of scalp and skin of neck Other malignant neoplasm of skin of trunk, except scrotum Other malignant neoplasm of skin of upper limb, including shoulder Other malignant neoplasm of skin of lower limb, including hip Other malignant neoplasm of other specified sites of skin Other malignant neoplasm of skin, site unspecified Malignant neoplasm of nipple and areola of female breast Malignant neoplasm of central portion of female breast Malignant neoplasm of upper-inner quadrant of female breast 1618 1619 1620 1622 1623 1624 1625 1628 1629 1638 1639 1640 1641 1649 1709 1710 1712 1713 1714 1715 1719 1722 1723 1724 1725 1726 1727 1728 1729 1730 1731 1732 1733 1734 1735 1736 1737 1738 1739 1740 1741 1742 118 Malignant neoplasm of lower-inner quadrant of female breast Malignant neoplasm of upper-outer quadrant of female breast Malignant neoplasm of lower-outer quadrant of female breast Malignant neoplasm of other specified sites of female breast Malignant neoplasm of breast (female), unspecified site Malignant neoplasm of other and unspecified sites of male breast Malignant neoplasm of uterus, part unspecified Malignant neoplasm of endocervix Malignant neoplasm of cervix uteri, unspecified site Malignant neoplasm of corpus uteri, except isthmus Malignant neoplasm of ovary Malignant neoplasm of fallopian tube Malignant neoplasm of vagina Malignant neoplasm of vulva, unspecified site Malignant neoplasm of prostate Malignant neoplasm of other and unspecified testis Malignant neoplasm of penis, part unspecified Malignant neoplasm of trigone of urinary bladder Malignant neoplasm of dome of urinary bladder Malignant neoplasm of lateral wall of urinary bladder Malignant neoplasm of anterior wall of urinary bladder Malignant neoplasm of posterior wall of urinary bladder Malignant neoplasm of bladder neck Malignant neoplasm of ureteric orifice Malignant neoplasm of other specified sites of bladder Malignant neoplasm of bladder, part unspecified Malignant neoplasm of kidney, except pelvis Malignant neoplasm of renal pelvis Malignant neoplasm of ureter Malignant neoplasm of urethra Malignant neoplasm of urinary organ, site unspecified Malignant neoplasm of choroid Malignant neoplasm of cerebrum, except lobes and ventricles Malignant neoplasm of frontal lobe of brain Malignant neoplasm of temporal lobe of brain Malignant neoplasm of parietal lobe of brain Malignant neoplasm of occipital lobe of brain Malignant neoplasm of other parts of brain Malignant neoplasm of brain, unspecified site Malignant neoplasm of cerebral meninges Malignant neoplasm of thyroid gland Malignant neoplasm of adrenal gland Malignant neoplasm of head, face, and neck 1743 1744 1745 1748 1749 1759 179 1800 1809 1820 1830 1832 1840 1844 185 1869 1874 1880 1881 1882 1883 1884 1885 1886 1888 1889 1890 1891 1892 1893 1899 1906 1910 1911 1912 1913 1914 1918 1919 1921 193 1940 1950 119 Malignant neoplasm of thorax Malignant neoplasm of abdomen Secondary and unspecified malignant neoplasm of lymph nodes of head, face, and neck Secondary and unspecified malignant neoplasm of intrathoracic lymph nodes Secondary and unspecified malignant neoplasm of intra-abdominal lymph nodes Secondary and unspecified malignant neoplasm of lymph nodes of axilla and upper limb Secondary and unspecified malignant neoplasm of lymph nodes of inguinal region and lower limb Secondary malignant neoplasm of lung Secondary malignant neoplasm of mediastinum Secondary malignant neoplasm of pleura Secondary malignant neoplasm of small intestine including duodenum Secondary malignant neoplasm of large intestine and rectum Secondary malignant neoplasm of retroperitoneum and peritoneum Secondary malignant neoplasm of liver Secondary malignant neoplasm of other digestive organs and spleen Secondary malignant neoplasm of kidney Secondary malignant neoplasm of other urinary organs Secondary malignant neoplasm of skin Secondary malignant neoplasm of brain and spinal cord Secondary malignant neoplasm of other parts of nervous system Secondary malignant neoplasm of bone and bone marrow Secondary malignant neoplasm of adrenal gland Secondary malignant neoplasm of breast Secondary malignant neoplasm of genital organs Secondary malignant neoplasm of other specified sites Disseminated malignant neoplasm Other malignant neoplasm of unspecified site Mantle cell lymphoma, unspecified site, extranodal and solid organ sites Large cell lymphoma, unspecified site, extranodal and solid organ sites Hodgkin's disease, unspecified type, unspecified site, extranodal and solid organ sites Nodular lymphoma, unspecified site, extranodal and solid organ sites Nodular lymphoma of lymph nodes of head, face, and neck Nodular lymphoma of intra-abdominal lymph nodes Nodular lymphoma of lymph nodes of multiple sites Mycosis fungoides, unspecified site, extranodal and solid organ sites Leukemic reticuloendotheliosis, unspecified site, extranodal and solid organ sites Other malignant lymphomas, unspecified site, extranodal and solid organ sites Other malignant lymphomas of lymph nodes of head, face, and neck Other malignant lymphomas of intrathoracic lymph nodes Other malignant lymphomas of intra-abdominal lymph nodes 1951 1952 1960 1961 1962 1963 1965 1970 1971 1972 1974 1975 1976 1977 1978 1980 1981 1982 1983 1984 1985 1987 19881 19882 19889 1990 1991 20040 20070 20190 20200 20201 20203 20208 20210 20240 20280 20281 20282 20283 120 Other malignant lymphomas of lymph nodes of axilla and upper limb Other malignant lymphomas of lymph nodes of inguinal region and lower limb Other malignant lymphomas of lymph nodes of multiple sites Multiple myeloma, without mention of having achieved remission Multiple myeloma in remission Acute lymphoid leukemia, without mention of having achieved remission Chronic lymphoid leukemia, without mention of having achieved remission Chronic lymphoid leukemia in remission Unspecified lymphoid leukemia, without mention of having achieved remission Acute myeloid leukemia, without mention of having achieved remission Acute myeloid leukemia in remission Chronic myeloid leukemia, without mention of having achieved remission Acute leukemia of unspecified cell type, without mention of having achieved remission Chronic leukemia of unspecified cell type, without mention of having achieved remission Unspecified leukemia, without mention of having achieved remission Malignant carcinoid tumor of the bronchus and lung Benign neoplasm of bronchus and lung Benign neoplasm of heart Benign neoplasm of brain Benign neoplasm of cerebral meninges Benign neoplasm of spinal meninges Carcinoma in situ of esophagus Carcinoma in situ of stomach Carcinoma in situ of colon Carcinoma in situ of rectum Carcinoma in situ of larynx Carcinoma in situ of bronchus and lung Carcinoma in situ of breast Carcinoma in situ of cervix uteri Carcinoma in situ of other and unspecified parts of uterus Carcinoma in situ, other and unspecified female genital organs Carcinoma in situ, vulva Carcinoma in situ of prostate Carcinoma in situ of bladder Carcinoma in situ of other specified sites Neoplasm of uncertain behavior of major salivary glands Neoplasm of uncertain behavior of lip, oral cavity, and pharynx Neoplasm of uncertain behavior of stomach, intestines, and rectum Neoplasm of uncertain behavior of liver and biliary passages Neoplasm of uncertain behavior of other and unspecified digestive organs Neoplasm of uncertain behavior of larynx Neoplasm of uncertain behavior of trachea, bronchus, and lung 20284 20285 20288 20300 20301 20400 20410 20411 20490 20500 20501 20510 20800 20810 20890 20921 2123 2127 2250 2252 2254 2301 2302 2303 2304 2310 2312 2330 2331 2332 2333 23332 2334 2337 2348 2350 2351 2352 2353 2355 2356 2357 121 Neoplasm of uncertain behavior of ovary Neoplasm of uncertain behavior of prostate Neoplasm of uncertain behavior of bladder Neoplasm of uncertain behavior of kidney and ureter Neoplasm of uncertain behavior of pituitary gland and craniopharyngeal duct Neoplasm of uncertain behavior of other and unspecified endocrine glands Neoplasm of uncertain behavior of brain and spinal cord Neoplasm of uncertain behavior of bone and articular cartilage Neoplasm of uncertain behavior of connective and other soft tissue Neoplasm of uncertain behavior of skin Neoplasm of uncertain behavior of breast Neoplasm of uncertain behavior of polycythemia vera Essential thrombocythemia Low grade myelodysplastic syndrome lesions High grade myelodysplastic syndrome lesions Myelodysplastic syndrome, unspecified Myelofibrosis with myeloid metaplasia Neoplasm of uncertain behavior of other specified sites Neoplasm of uncertain behavior, site unspecified Neoplasm of unspecified nature of digestive system Neoplasm of unspecified nature of respiratory system Neoplasms of unspecified nature of bone, soft tissue, and skin Neoplasm of unspecified nature of breast Neoplasm of unspecified nature of bladder Neoplasm of unspecified nature of other genitourinary organs Neoplasm of unspecified nature of brain Neoplasm of unspecified nature of endocrine glands and other parts of nervous system Neoplasm of unspecified nature of other specified sites Neoplasms of unspecified nature, other specified sites Neoplasm of unspecified nature, site unspecified Thyrotoxicosis of other specified origin without mention of thyrotoxic crisis or storm Thyrotoxicosis without mention of goiter or other cause, without mention of thyrotoxic crisis or storm Thyrotoxicosis without mention of goiter or other cause, with mention of thyrotoxic crisis Acute thyroiditis Unspecified thyroiditis Diabetes with ketoacidosis, type II or unspecified type, not stated as uncontrolled Diabetes with ketoacidosis, type I [juvenile type], not stated as uncontrolled Diabetes with ketoacidosis, type II or unspecified type, uncontrolled Diabetes with ketoacidosis, type I [juvenile type], uncontrolled Diabetes with hyperosmolarity, type II or unspecified type, not stated as 2362 2365 2367 23691 2370 2374 2375 2380 2381 2382 2383 2384 23871 23872 23873 23875 23876 2388 2389 2390 2391 2392 2393 2394 2395 2396 2397 2398 23989 2399 24280 24290 24291 2450 2459 25010 25011 25012 25013 25020 122 uncontrolled Diabetes with hyperosmolarity, type II or unspecified type, uncontrolled Diabetes with other coma, type II or unspecified type, not stated as uncontrolled Diabetes with other coma, type II or unspecified type, uncontrolled Diabetes with other coma, type I [juvenile type], uncontrolled Hypoglycemic coma Other specified hypoglycemia Hypoglycemia, unspecified Diabetes insipidus Glucocorticoid deficiency Carcinoid syndrome Nutritional marasmus Other severe protein-calorie malnutrition Unspecified protein-calorie malnutrition Other and unspecified manifestations of thiamine deficiency Disturb sulphur amino acid metabol Monoclonal paraproteinemia Disorders of iron metabolism Disorders of magnesium metabolism Disorders of phosphorus metabolism Unspecified disorder of calcium metabolism Hypocalcemia Hypercalcemia Other disorders of calcium metabolism Hyperosmolality and/or hypernatremia Hyposmolality and/or hyponatremia Acidosis Alkalosis Mixed acid-base balance disorder Volume depletion, unspecified Dehydration Hypovolemia Fluid overload Fluid overload nec (other fluid overload) Hyperpotassemia Hypopotassemia Electrolyte and fluid disorders not elsewhere classified Cystic fibrosis without mention of meconium ileus Cystic fibrosis with pulmonary manifestations Amyloidosis Amyloidosis, unspecified Other amyloidosis Unspecified disorder of metabolism 25022 25030 25032 25033 2510 2511 2512 2535 25541 2592 261 262 2639 2651 2704 2731 2750 2752 2753 27540 27541 27542 27549 2760 2761 2762 2763 2764 27650 27651 27652 2766 27669 2767 2768 2769 27700 27702 2773 27730 27739 2779 123 Autoimmune disease other Iron deficiency anemia secondary to blood loss (chronic) Iron deficiency anemia secondary to inadequate dietary iron intake Other specified iron deficiency anemias Unspecified iron deficiency anemia Pernicious anemia Other vitamin B12 deficiency anemia Folate-deficiency anemia Other specified megaloblastic anemias not elsewhere classified Anemia associated with other specified nutritional deficiency Unspecified deficiency anemia Other thalassemia Sickle-cell disease, unspecified Hb-SS disease with crisis Sickle-cell/Hb-C disease with crisis Other sickle-cell disease with crisis Autoimmune hemolytic anemias Other non-autoimmune hemolytic anemias Acquired hemolytic anemia, unspecified Pancytopenia Other pancytopenia Other specified aplastic anemias Red cell aplasia (acquired) (adult) (with thymoma) Other specified aplastic anemias Unspecified aplastic anemia Sideroblastic anemia Acute posthemorrhagic anemia Anemia in chronic kidney disease Anemia in neoplastic disease Anemia of other chronic disease Chemotherapy induced anemia Other specified anemias Unspecified anemia Hemorrhagic disorder due to intrinsic circulating anticoagulants Defibrination syndrome Oth nonthrombocytopenic purpuras Primary thrombocytopenia unspec Immune thrombocytopenic purpura Uns thrombocytopenia Unspecified hemorrhagic conditions Neutropenia, unspecified Functional disord neutrophils Leukocytopenia unspecified 2794 2800 2801 2808 2809 2810 2811 2812 2813 2818 2819 28249 28260 28262 28264 28269 2830 28319 2839 2841 28419 2848 28481 28489 2849 2850 2851 28521 28522 28529 2853 2858 2859 2865 2866 2872 28730 28731 2875 2879 28800 2881 28850 124 Leukocytosis unspecified Other disease white blood cells Polycythemia, secondary Myelofibrosis Ot dis blood/blood forming organs Uns dis blood/blood forming organs Senile dementia with delirium Vascular dementia, with delirium Unspecified senile psychotic condition Alcohol withdrawal delirium Alcohol withdrawal Drug withdrawal Drug-induced psychotic disorder with hallucinations Drug-induced delirium Drug-induced mood disorder Other specified drug-induced mental disorder Unspecified drug-induced mental disorder Delirium due to conditions classified elsewhere Subacute delirium Mood disorder in conditions classified elsewhere Anxiety disorder in conditions classified elsewhere Unspecified transient mental disorder in conditions classified elsewhere Other persistent mental disorders due to conditions classified elsewhere Unspecified persistent mental disorders due to conditions classified elsewhere Simple schizophrenia, unspecified condition Catatonic schizophrenia, unspecified condition Paranoid schizophrenia, unspecified condition Paranoid schizophrenia, chronic condition Paranoid schizophrenia, chronic condition with acute exacerbation Schizophreniform disorder, unspecified Schizophrenic disorders, residual type, unspecified Schizoaffective disorder, unspecified Schizoaffective disorder, chronic Schizoaffective disorder, chronic with acute exacerbation Other specified types of schizophrenia, unspecified condition Other specified types of schizophrenia, chronic condition with acute exacerbation Unspecified schizophrenia, unspecified condition Unspecified schizophrenia, chronic condition Unspecified schizophrenia, chronic condition with acute exacerbation Bipolar I disorder, single manic episode, unspecified Major depressive disorder, single episode, unspecified Major depressive disorder, single episode, mild Major depressive disorder, single episode, moderate 28860 2888 2890 28983 28989 2899 2903 29041 2909 2910 29181 2920 29212 29281 29284 29289 2929 2930 2931 29383 29384 2939 2948 2949 29500 29520 29530 29532 29534 29540 29560 29570 29572 29574 29580 29584 29590 29592 29594 29600 29620 29621 29622 125 Major depressive disorder, single episode, severe, without mention of psychotic behavior Major depressive disorder, single episode, severe, specified as with psychotic behavior Major depressive disorder, recurrent episode, unspecified Major depressive disorder, recurrent episode, mild Major depressive disorder, recurrent episode, moderate Major depressive disorder, recurrent episode, severe, without mention of psychotic behavior Major depressive disorder, recurrent episode, severe, specified as with psychotic behavior Bipolar I disorder, most recent episode (or current) manic, unspecified Bipolar I disorder, most recent episode (or current) manic, severe, without mention of psychotic behavior Bipolar I disorder, most recent episode (or current) manic, severe, specified as with psychotic behavior Bipolar I disorder, most recent episode (or current) depressed, unspecified Bipolar I disorder, most recent episode (or current) depressed, moderate Bipolar I disorder, most recent episode (or current) depressed, severe, without mention of psychotic behavior Bipolar I disorder, most recent episode (or current) depressed, severe, specified as with psychotic behavior Bipolar I disorder, most recent episode (or current) mixed, unspecified Bipolar I disorder, most recent episode (or current) mixed, moderate Bipolar I disorder, most recent episode (or current) mixed, severe, without mention of psychotic behavior Bipolar I disorder, most recent episode (or current) mixed, severe, specified as with psychotic behavior Bipolar I disorder, most recent episode (or current) unspecified Bipolar disorder, unspecified Atypical depressive disorder Unspecified episodic mood disorder Other specified episodic mood disorder Delusional disorder Unspecified paranoid state Reactive confusion Other and unspecified reactive psychosis Unspecified psychosis Autistic disorder, current or active state Anxiety state, unspecified Panic disorder wo agoraphobia Generalized anxiety disorder Other anxiety states Conversion disorder Obsessive-compulsive disorders 29623 29624 29630 29631 29632 29633 29634 29640 29643 29644 29650 29652 29653 29654 29660 29662 29663 29664 2967 29680 29682 29690 29699 2971 2979 2982 2988 2989 29900 30000 30001 30002 30009 30011 3003 126 Dysthymic disorder Unspecified nonpsychotic mental disorder Borderline personality disorder Psychosex dysfunc inhibited excite Acute alcoholic intoxication, unspecified drunkenness Acute alcoholic intoxication, continuous drunkenness Acute alcoholic intoxication, episodic drunkenness Other and unspecified alcohol dependence, unspecified drunkenness Other and unspecified alcohol dependence, continuous drunkenness Opioid type dependence, unspecified abuse Opioid type dependence, continuous abuse Cocaine dependence, unspecified abuse Cocaine dependence, continuous abuse Combinations of opioid type drug with any other drug dependence, continuous abuse Combinations of drug dependence excluding opioid type drug, unspecified abuse Unspecified drug dependence, unspecified abuse Nondependent alcohol abuse, unspecified drunkenness Nondependent alcohol abuse, continuous drunkenness Nondependent alcohol abuse, episodic drunkenness Nondependent cannabis abuse, unspecified Nondependent sedative, hypnotic or anxiolytic abuse, unspecified Nondependent opioid abuse, unspecified Nondependent cocaine abuse, unspecified Nondependent amphetamine or related acting sympathomimetic abuse, unspecified Other, mixed, or unspecified nondependent drug abuse, unspecified Respiratory malfunction arising from mental factors Cardiovascular malfunction arising from mental factors Anorexia nervosa Eating disorder, unspecified Predominant disturbance of emotions Unspecified acute reaction to stress Adjustment disorder with depressed mood Prolonged depressive reaction as adjustment reaction Adjustment disorder with anxiety Adjustment disorder with mixed anxiety and depressed mood Adjustment disorder with mixed disturbance of emotions and conduct Posttraumatic stress disorder Unspecified adjustment reaction Personality change due to conditions classified elsewhere Postconcussion syndrome Unspecified nonpsychotic mental disorder following organic brain damage Depressive disorder, not elsewhere classified 3004 3009 30183 30272 30300 30301 30302 30390 30391 30400 30401 30420 30421 30471 30480 30490 30500 30501 30502 30520 30540 30550 30560 30570 30590 3061 3062 3071 30750 3080 3089 3090 3091 30924 30928 3094 30981 3099 3101 3102 3109 311 127 Impulse control disorder, unspecified Intermittent explosive disorder Attention deficit disorder of childhood without mention of hyperactivity Attention deficit disorder of childhood with hyperactivity Meningitis due to unspecified bacterium Unspecified meningitis Unspecified causes of encephalitis, myelitis, and encephalomyelitis Intracranial abscess Idiopathic sleep related nonobstructive alveolar hypoventilation Confusional arousals Communicating hydrocephalus Obstructive hydrocephalus Idiopathic normal pressure hydrocephalus [INPH] Paralysis agitans Secondary parkinsonism Subacute dyskinesia due to drugs Neuroleptic malignant syndrome Carotid sinus syndrome Acute pain due to trauma Acute post-thoracotomy pain Other acute postoperative pain Other acute pain Neoplasm related pain (acute) (chronic) Multiple sclerosis Unspecified infantile cerebral palsy Other specified paralytic syndrome Unspecified paralysis Other forms of epilepsy and recurrent seizures, without mention of intractable epilepsy Migraine with aura, without mention of intractable migraine without mention of status migrainosus Migraine with aura, with intractable migraine, so stated, without mention of status migrainosus Migraine without aura, without mention of intractable migraine without mention of status migrainosus Migraine without aura, with intractable migraine, so stated, without mention of status migrainosus Variants of migraine, not elsewhere classified, without mention of intractable migraine without mention of status migrainosus Variants of migraine, not elsewhere classified, with intractable migraine, so stated, without mention of status migrainosus Chronic migraine without aura, with intractable migraine, so stated, without mention of status migrainosus Other forms of migraine, without mention of intractable migraine without mention of status migrainosus 31230 31234 31400 31401 3209 3229 3239 3240 32724 32741 3313 3314 3315 3320 3321 33385 33392 33701 33811 33812 33818 33819 3383 340 3439 34489 3449 34580 34600 34601 34610 34611 34620 34621 34671 34680 128 Migraine, unspecified with intractable migraine, so stated, without mention of status migrainosus Narcolepsy, without cataplexy Anoxic brain damage Benign intracranial hypertension Encephalopathy, unspecified Metabolic encephalopathy Other encephalopathy Cerebral edema Toxic encephalopathy Atypical face pain Unspecified inflammatory and toxic neuropathy Myasthenia gravis without (acute) exacerbation Myasthenia gravis with (acute) exacerbation Myotonic muscular dystrophy Toxic myopathy Unspecified retinal vascular occlusion Central artery occlusion of retina Arterial branch occlusion of retina Partial arterial occlusion of retina Transient arterial occlusion of retina Central vein occlusion of retina Sudden visual loss Transient visual loss Psychophysical visual disturbances Other visual disturbances Unspecified visual disturbance Impairment level not further specified Unspecified visual loss Uns peripheral vertigo Benign paroxysmal position vertigo Rheumatic fever without mention of heart involvement Acute rheumatic pericarditis Acute rheumatic endocarditis Other acute rheumatic heart disease Unspecified acute rheumatic heart disease Mitral stenosis Rheumatic mitral insufficiency Mitral stenosis with insufficiency Other and unspecified mitral valve diseases Rheumatic aortic stenosis Rheumatic aortic insufficiency Rheumatic aortic stenosis with insufficiency 34691 34700 3481 3482 34830 34831 34839 3485 34982 3502 3579 35800 35801 35921 3594 36230 36231 36232 36233 36234 36235 36811 36812 36816 3688 3689 36960 3699 38610 38611 390 3910 3911 3918 3919 3940 3941 3942 3949 3950 3951 3952 129 Other and unspecified rheumatic aortic diseases Mitral valve stenosis and aortic valve stenosis Mitral valve stenosis and aortic valve insufficiency Mitral valve insufficiency and aortic valve stenosis Mitral valve insufficiency and aortic valve insufficiency Multiple involvement of mitral and aortic valves Unspecified mitral and aortic valve diseases Diseases of tricuspid valve Rheumatic diseases of pulmonary valve Unspecified rheumatic heart disease Rheumatic heart failure (congestive) Other and unspecified rheumatic heart diseases Essential hypertension, malignant Malignant hypertensive heart disease without heart failure Malignant hypertensive heart disease with heart failure Benign hypertensive heart disease without heart failure Benign hypertensive heart disease with heart failure Unspecified hypertensive heart disease without heart failure Hypertensive heart disease, unspecified, with heart failure Mal kid hyper w ckd stage i-iv Hypertensive heart and chronic kidney disease, malignant, without heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, malignant, with heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, malignant, without heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, malignant, with heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, benign, without heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, benign, with heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, benign, without heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, benign, with heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, unspecified, without heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, unspecified, with heart failure and with chronic kidney disease stage I-IV Hypertensive heart and chronic kidney disease, unspecified, without heart failure and with chronic kidney disease stage V Hypertensive heart and chronic kidney disease, unspecified, with heart failure and with chronic kidney disease stage V Secondary renovascular hypertension, malignant 3959 3960 3961 3962 3963 3968 3969 3970 3971 39890 39891 39899 4010 40200 40201 40210 40211 40290 40291 40300 40400 40401 40402 40403 40410 40411 40412 40413 40490 40491 40492 40493 40501 130 Other secondary hypertension, malignant Acute myocardial infarction of anterolateral wall, episode of care unspecified Acute myocardial infarction of anterolateral wall, initial episode of care Acute myocardial infarction of anterolateral wall, subsequent episode of care Acute myocardial infarction of other anterior wall, episode of care unspecified Acute myocardial infarction of other anterior wall, initial episode of care Acute myocardial infarction of other anterior wall, subsequent episode of care Acute myocardial infarction of inferolateral wall, episode of care unspecified Acute myocardial infarction of inferolateral wall, initial episode of care Acute myocardial infarction of inferolateral wall, subsequent episode of care Acute myocardial infarction of inferoposterior wall, episode of care unspecified Acute myocardial infarction of inferoposterior wall, initial episode of care Acute myocardial infarction of inferoposterior wall, subsequent episode of care Acute myocardial infarction of other inferior wall, episode of care unspecified Acute myocardial infarction of other inferior wall, initial episode of care Acute myocardial infarction of other inferior wall, subsequent episode of care Acute myocardial infarction of other lateral wall, episode of care unspecified Acute myocardial infarction of other lateral wall, initial episode of care Acute myocardial infarction of other lateral wall, subsequent episode of care Acute myocardial infarction, true posterior wall infarction, episode of care unspecified Acute myocardial infarction, true posterior wall infarction, initial episode of care Acute myocardial infarction, true posterior wall infarction, subsequent episode of care Acute myocardial infarction, subendocardial infarction, episode of care unspecified Acute myocardial infarction, subendocardial infarction, initial episode of care Acute myocardial infarction, subendocardial infarction, subsequent episode of care Acute myocardial infarction of other specified sites, episode of care unspecified Acute myocardial infarction of other specified sites, initial episode of care Acute myocardial infarction of other specified sites, subsequent episode of care Acute myocardial infarction, unspecified site, episode of care unspecified Acute myocardial infarction, unspecified site, initial episode of care Acute myocardial infarction, unspecified site, subsequent episode of care Postmyocardial infarction syndrome Intermediate coronary syndrome Acute coronary occlusion without myocardial infarction Other acute and subacute form of ischemic heart disease Old myocardial infarction Angina decubitus Prinzmetal angina Other and unspecified angina pectoris Coronary atherosclerosis of unspecified type of vessel, native or graft Coronary atherosclerosis of native coronary artery 40509 41000 41001 41002 41010 41011 41012 41020 41021 41022 41030 41031 41032 41040 41041 41042 41050 41051 41052 41060 41061 41062 41070 41071 41072 41080 41081 41082 41090 41091 41092 4110 4111 41181 41189 412 4130 4131 4139 41400 41401 131 Coronary atherosclerosis of autologous vein bypass graft Coronary atherosclerosis of nonautologous biological bypass graft Coronary atherosclerosis of artery bypass graft Coronary atherosclerosis of unspecified type of bypass graft Coronary atherosclerosis, of native coronary artery of transplanted heart Coronary atherosclerosis, of bypass graft (artery) (vein) of transplanted heart Aneurysm of heart Aneurysm of coronary vessels Dissection of coronary artery Other aneurysm of heart Chronic total occlusion of coronary artery Coronary atherosclerosis due to lipid rich plaque Other specified forms of chronic ischemic heart disease Unspecified chronic ischemic heart disease Acute cor pulmonale Iatrogenic pulmonary embolism and infarction Septic pulmonary embolism Other pulmonary embolism and infarction Primary pulmonary hypertension Chronic pulmonary embolism Other chronic pulmonary heart diseases Unspecified chronic pulmonary heart disease Arteriovenous fistula of pulmonary vessels Aneurysm of pulmonary artery Other specified disease of pulmonary circulation Unspecified disease of pulmonary circulation Acute pericarditis in diseases classified elsewhere Unspecified acute pericarditis Acute idiopathic pericarditis Other acute pericarditis Acute and subacute bacterial endocarditis Acute and subacute infective endocarditis in diseases classified elsewhere Unspecified acute endocarditis Unspecified acute myocarditis Idiopathic myocarditis Hemopericardium Adhesive pericarditis Constrictive pericarditis Cardiac tamponade Other specified diseases of pericardium Unspecified disease of pericardium Mitral valve disorders Aortic valve disorders 41402 41403 41404 41405 41406 41407 41410 41411 41412 41419 4142 4143 4148 4149 4150 41511 41512 41519 4160 4162 4168 4169 4170 4171 4178 4179 4200 42090 42091 42099 4210 4211 4219 42290 42291 4230 4231 4232 4233 4238 4239 4240 4241 132 Tricuspid valve disorders, specified as nonrheumatic Pulmonary valve disorders Endocarditis, valve unspecified, unspecified cause Endocarditis in diseases classified elsewhere Other endocarditis, valve unspecified Endomyocardial fibrosis Hypertrophic obstructive cardiomyopathy Hypertrophic obstructive cardiomyopathy Other hypertrophic cardiomyopathy Obscure cardiomyopathy of Africa Endocardial fibroelastosis Other primary cardiomyopathies Alcoholic cardiomyopathy Nutritional and metabolic cardiomyopathy Cardiomyopathy in other diseases classified elsewhere Unspecified secondary cardiomyopathy Atrioventricular block, complete Unspecified atrioventricular block First degree atrioventricular block Mobitz (type) II atrioventricular block Other second degree atrioventricular block Left bundle branch hemiblock Other left bundle branch block Right bundle branch block Unspecified bundle branch block Right bundle branch block and left posterior fascicular block Right bundle branch block and left anterior fascicular block Other bilateral bundle branch block Trifascicular block Other heart block Anomalous atrioventricular excitation Lown-Ganong-Levine syndrome Long QT syndrome Other specified conduction disorder Unspecified conduction disorder Paroxysmal supraventricular tachycardia Paroxysmal ventricular tachycardia Unspecified paroxysmal tachycardia Atrial fibrillation Atrial flutter Ventricular fibrillation Ventricular flutter Cardiac arrest 4242 4243 42490 42491 42499 4250 4251 42511 42518 4252 4253 4254 4255 4257 4258 4259 4260 42610 42611 42612 42613 4262 4263 4264 42650 42651 42652 42653 42654 4266 4267 42681 42682 42689 4269 4270 4271 4272 42731 42732 42741 42742 4275 133 Unspecified premature beats Supraventricular premature beats Other premature beats Sinoatrial node dysfunction Other specified cardiac dysrhythmias Unspecified cardiac dysrhythmia Congestive heart failure, unspecified Left heart failure Unspecified systolic heart failure Acute systolic heart failure Chronic systolic heart failure Acute on chronic systolic heart failure Unspecified diastolic heart failure Acute diastolic heart failure Chronic diastolic heart failure Acute on chronic diastolic heart failure Unspecified combined systolic and diastolic heart failure Acute combined systolic and diastolic heart failure Chronic combined systolic and diastolic heart failure Acute on chronic combined systolic and diastolic heart failure Unspecified heart failure Unspecified myocarditis Myocardial degeneration Unspecified cardiovascular disease Cardiomegaly Functional disturbances following cardiac surgery Rupture of chordae tendineae Rupture of papillary muscle Acquired cardiac septal defect Other certain sequelae of myocardial infarction, not elsewhere classified Other disorders of papillary muscle Hyperkinetic heart disease Takotsubo syndrome Other ill-defined heart disease Unspecified heart disease Subarachnoid hemorrhage Intracerebral hemorrhage Nontraumatic extradural hemorrhage Subdural hemorrhage Unspecified intracranial hemorrhage Occlusion and stenosis of basilar artery without mention of cerebral infarction Occlusion and stenosis of basilar artery with cerebral infarction Occlusion and stenosis of carotid artery without mention of cerebral infarction 42760 42761 42769 42781 42789 4279 4280 4281 42820 42821 42822 42823 42830 42831 42832 42833 42840 42841 42842 42843 4289 4290 4291 4292 4293 4294 4295 4296 42971 42979 42981 42982 42983 42989 4299 430 431 4320 4321 4329 43300 43301 43310 134 Occlusion and stenosis of carotid artery with cerebral infarction Occlusion and stenosis of vertebral artery without mention of cerebral infarction Occlusion and stenosis of vertebral artery with cerebral infarction Occlusion and stenosis of multiple and bilateral precerebral arteries without mention of c Occlusion and stenosis of multiple and bilateral precerebral arteries with cerebral infarc Occlusion and stenosis of other specified precerebral artery without mention of cerebral i Occlusion and stenosis of other specified precerebral artery with cerebral infarction Occlusion and stenosis of unspecified precerebral artery without mention of cerebral infar Occlusion and stenosis of unspecified precerebral artery with cerebral infarction Cerebral thrombosis without mention of cerebral infarction Cerebral thrombosis with cerebral infarction Cerebral embolism without mention of cerebral infarction Cerebral embolism with cerebral infarction Unspecified cerebral artery occlusion without mention of cerebral infarction Unspecified cerebral artery occlusion with cerebral infarction Basilar artery syndrome Vertebral artery syndrome Subclavian steal syndrome Vertebrobasilar artery syndrome Other specified transient cerebral ischemias Unspecified transient cerebral ischemia Acute, but ill-defined, cerebrovascular disease Cerebral atherosclerosis Other generalized ischemic cerebrovascular disease Hypertensive encephalopathy Cerebral aneurysm, nonruptured Transient global amnesia Unspecified cerebrovascular disease Hemiplegia affecting unspecified side due to cerebrovascular disease Vertigo Uns late effects cv disease Atherosclerosis of aorta Atherosclerosis of renal artery Atherosclerosis of native arteries of the extremities, unspecified Atherosclerosis of native arteries of the extremities with intermittent claudication Atherosclerosis of native arteries of the extremities with rest pain Atherosclerosis of native arteries of the extremities with ulceration Atherosclerosis of native arteries of the extremities with gangrene Other atherosclerosis of native arteries of the extremities 43311 43320 43321 43330 43331 43380 43381 43390 43391 43400 43401 43410 43411 43490 43491 4350 4351 4352 4353 4358 4359 436 4370 4371 4372 4373 4377 4379 43820 43885 4389 4400 4401 44020 44021 44022 44023 44024 44029 135 Atherosclerosis of unspecified bypass graft of extremities Atherosclerosis of autologous vein bypass graft of extremities Chronic total occlusion of artery of the extremities Atherosclerosis of other specified arteries Generalized and unspecified atherosclerosis Dissecting aortic aneurysm (any part), unspecified site Dissecting aortic aneurysm (any part), thoracic Dissecting aortic aneurysm (any part), abdominal Dissecting aortic aneurysm (any part), thoracoabdominal Thoracic aneurysm, ruptured Thoracic aneurysm without mention of rupture Abdominal aneurysm, ruptured Abdominal aneurysm without mention of rupture Aortic aneurysm of unspecified site, ruptured Thoracoabdominal aneurysm, ruptured Thoracoabdominal aneurysm without mention of rupture Aortic aneurysm of unspecified site without mention of rupture Aneurysm of artery of upper extremity Aneurysm of renal artery Aneurysm of iliac artery Aneurysm of artery of lower extremity Aneurysm of artery of neck Aneurysm of splenic artery Aneurysm of other visceral artery Aneurysm of other specified artery Other aneurysm of unspecified site Raynaud's syndrome Thromboangiitis obliterans (Buerger's disease) Dissection of carotid artery Dissection of other artery Peripheral angiopathy in diseases classified elsewhere Embolism and thrombosis of abdominal aorta Embolism and thrombosis of thoracic aorta Embolism and thrombosis of arteries of upper extremity Embolism and thrombosis of arteries of lower extremity Embolism and thrombosis of iliac artery Embolism and thrombosis of other specified artery Embolism and thrombosis of unspecified artery Atheroembolism of lower extremity Polyarteritis nodosa Wegener's granulomatosis Giant cell arteritis Takayasu's disease 44030 44031 4404 4408 4409 44100 44101 44102 44103 4411 4412 4413 4414 4415 4416 4417 4419 4420 4421 4422 4423 44281 44283 44284 44289 4429 4430 4431 44321 44329 44381 4440 4441 44421 44422 44481 44489 4449 44502 4460 4464 4465 4467 136 Stricture of artery Rupture of artery Celiac artery compression syndrome Unspecified arteritis Other specified disorders of arteries and arterioles Unspecified disorders of arteries and arterioles Portal vein thrombosis Embolism and thrombosis of vena cava Venous embolism and thrombosis of unspecified deep vessels of lower extremity Venous embolism and thrombosis of deep vessels of proximal lower extremity Venous embolism and thrombosis of deep vessels of distal lower extremity Chronic venous embolism and thrombosis of unspecified deep vessels of lower extremity Chronic venous embolism and thrombosis of deep vessels of proximal lower extremity Chronic venous embolism and thrombosis of deep vessels of distal lower extremity Emb/throm superficial lower ext Venous embolism and thrombosis of other specified veins Acute venous embolism and thrombosis of superficial veins of upper extremity Acute venous embolism and thrombosis of deep veins of upper extremity Acute venous embolism and thrombosis of upper extremity, unspecified Acute venous embolism and thrombosis of subclavian veins Acute venous embolism and thrombosis of internal jugular veins Embolism and thrombosis of unspecified site Esophageal varices with bleeding Other noninfectious lymphedema Orthostatic hypotension Chronic hypotension Hypotension of hemodialysis Other iatrogenic hypotension Other specified hypotension Unspecified hypotension Unspecified hemorrhage Unspecified circulatory system disorder Acute tracheitis without mention of obstruction Acute upper respiratory infections of other multiple sites Acute upper respiratory infections of unspecified site Acute bronchitis Acute bronchiolitis due to respiratory syncytial virus (RSV) Acute bronchiolitis due to other infectious organisms Other and unspecified diseases of upper respiratory tract Pneumonia adenovirus Pneumonia respiratory syncy virus 4471 4472 4474 4476 4478 4479 452 4532 45340 45341 45342 45350 45351 45352 4536 4538 45381 45382 45383 45385 45386 4539 4560 4571 4580 4581 45821 45829 4588 4589 4590 4599 46410 4658 4659 4660 46611 46619 4789 4800 4801 137 Uns viral pneumonia Pneumococcal pneumonia Pneumonia other bacteria Uns bacterial pneumonia Bronchopneumonia organism unspec Pneumonia organism unspecified Influenza with pneumonia Influenza w oth respiratory manif Bronchitis, not specified as acute or chronic Obstructive chronic bronchitis, with (acute) exacerbation Obstructive chronic bronchitis with acute bronchitis Emphysematous bleb Other emphysema Extrinsic asthma, unspecified Extrinsic asthma with status asthmaticus Extrinsic asthma, with (acute) exacerbation Intrinsic asthma, unspecified Intrinsic asthma with status asthmaticus Intrinsic asthma, with (acute) exacerbation Chronic obstructive asthma with status asthmaticus Chronic obstructive asthma, with (acute) exacerbation Cough variant asthma Asthma, unspecified, unspecified status Asthma, unspecified with status asthmaticus Asthma, unspecified, with (acute) exacerbation Bronchiectasis with acute exacerbation Coal workers' pneumoconiosis Asbestosis Acute pulmonary edema due to fumes and vapors Other acute and subacute respiratory conditions due to fumes and vapors Pneumonitis inhalation food Acute pulmonary manifestations due to radiation Empyema without mention of fistula Pleurisy without mention of effusion or current tuberculosis Pleurisy with effusion, with mention of bacterial cause other than tuberculosis Other specified forms of pleural effusion, except tuberculous Malignant pleural effusion Other specified forms of effusion, except tuberculous Unspecified pleural effusion Spontaneous tension pneumothorax Iatrogenic pneumothorax Other spontaneous pneumothorax Other pneumothorax 4809 481 48289 4829 485 486 4870 4871 490 49121 49122 4920 4928 49300 49301 49302 49310 49311 49312 49321 49322 49382 49390 49391 49392 4941 500 501 5061 5063 5070 5080 5109 5110 5111 5118 51181 51189 5119 5120 5121 5128 51289 138 Abscess of lung Pulmonary congestion and hypostasis Postinflammatory pulmonary fibrosis Idiopathic fibrosing alveolitis Other specified alveolar and parietoalveolar pneumonopathies Uns alveolar pneumonopathy Acute chest syndrome Lung involvement in other diseases classified elsewhere Pulmonary collapse Compensatory emphysema Pulmonary eosinophilia Unspecified acute edema of lung Pulmonary insufficiency following trauma and surgery Acute respiratory failure following trauma and surgery Acute respiratory failure Other pulmonary insufficiency, not elsewhere classified Chronic respiratory failure Acute and chronic respiratory failure Other diseases of lung, not elsewhere classified Unspecified tracheostomy complication Mechanical complication of tracheostomy Other tracheostomy complications Other diseases of trachea and bronchus, not elsewhere classified Acute bronchospasm Other diseases of trachea and bronchus Disorders diaphragm Other diseases of respiratory system, not elsewhere classified Unspecified disease of respiratory system Inflammatory conditions of jaw Mucositis (ulcerative) due to antineoplastic therapy Achalasia and cardiospasm Unspecified esophagitis Reflux esophagitis Acute esophagitis Other esophagitis Ulcer of esophagus with bleeding Stricture and stenosis of esophagus Perforation of esophagus Gastroesophageal laceration-hemorrhage syndrome Esophageal hemorrhage Unspecified disorder of esophagus Acute gastric ulcer with hemorrhage, without mention of obstruction Acute gastric ulcer with perforation, without mention of obstruction 5130 514 515 5163 5168 5169 5173 5178 5180 5182 5183 5184 5185 51851 51881 51882 51883 51884 51889 51900 51902 51909 5191 51911 51919 5194 5198 5199 5264 52801 5300 53010 53011 53012 53019 53021 5303 5304 5307 53082 5309 53100 53110 139 Chronic or unspecified gastric ulcer with hemorrhage, without mention of obstruction Chronic or unspecified gastric ulcer with hemorrhage and obstruction Chronic or unspecified gastric ulcer with perforation, without mention of obstruction Chronic or unspecified gastric ulcer with hemorrhage and perforation, without mention of obstruction Gastric ulcer, unspecified as acute or chronic, without mention of hemorrhage, perforation Acute duodenal ulcer with hemorrhage, without mention of obstruction Acute duodenal ulcer with hemorrhage and perforation, without mention of obstruction Duodenal ulcer, chronic or unspecified, with hemorrhage, without mention of obstruction Chronic or unspecified duodenal ulcer with hemorrhage and obstruction Chronic or unspecified duodenal ulcer with perforation, without mention of obstruction Chronic or unspecified duodenal ulcer with hemorrhage and perforation, without mention of obstruction Acute peptic ulcer, unspecified site, with hemorrhage, without mention of obstruction Chronic or unspecified peptic ulcer, unspecified site, with hemorrhage, without mention of obstruction Chronic or unspecified gastrojejunal ulcer with hemorrhage, without mention of obstruction Acute gastritis wohemorrhage Acute gastritis with hemorrhage Atrophic gastritis with hemorrhage Alcoholic gastritis without mention of hemorrhage Alcoholic gastritis with hemorrhage Other specified gastritis with hemorrhage Unspecified gastritis and gastroduodenitis with hemorrhage Duodenitis with hemorrhage Dyspepsia and other specified disorders of function of stomach Angiodysplasia of stomach and duodenum with hemorrhage Dieulafoy lesion (hemorrhagic) of stomach and duodenum Acute appendicitis with generalized peritonitis Acute appendicitis with peritoneal abscess Acute appendicitis without mention of peritonitis Appendicitis, unqualified Inguinal hernia with gangrene, unilateral or unspecified, (not specified as recurrent) Femoral hernia with gangrene, unilateral or unspecified (not specified as recurrent) Hernia of other specified site, with obstruction Uns ulcerative colitis 53140 53141 53150 53160 53190 53200 53220 53240 53241 53250 53260 53300 53340 53440 53500 53501 53511 53530 53531 53541 53551 53561 5368 53783 53784 5400 5401 5409 541 55000 55100 5528 5569 140 Acute vascular insufficiency of intestine Volvulus Gallstone ileus Fecal impaction Intestinal or peritoneal adhesions with obstruction (postoperative) (postinfection) Other specified intestinal obstruction Unspecified intestinal obstruction Diverticulosis of small intestine with hemorrhage Diverticulosis of colon with hemorrhage Diverticulitis of colon with hemorrhage Spontaneous bacterial peritonitis Unspecified peritonitis Hemorrhage of rectum and anus Perforation of intestine Angiodysplasia of intestine with hemorrhage Dieulafoy lesion (hemorrhagic) of intestine Acute and subacute necrosis of liver Abscess of liver Hepatic coma Portal hypertension Calculus of gallbladder with acute cholecystitis, without mention of obstruction Calculus of gallbladder with acute cholecystitis and obstruction Calculus of gallbladder with other cholecystitis, without mention of obstruction Calculus of gallbladder with other cholecystitis and obstruction Calculus of bile duct with acute cholecystitis without mention of obstruction Calculus of bile duct with acute cholecystitis and obstruction Calculus of gallbladder and bile duct with acute cholecystitis, with obstruction Calculus of gallbladder and bile duct with other cholecystitis, with obstruction Calculus of gallbladder and bile duct with acute and chronic cholecystitis, without mention of obstruction Calculus of gallbladder and bile duct with acute and chronic cholecystitis, with obstruction Acute cholecystitis Cholecystitis, unspecified Chronic cholecystitis Acute and chronic cholecystitis Perforation of gallbladder Cholangitis Acute pancreatitis Chronic pancreatitis Hematemesis Blood in stool Hemorrhage of gastrointestinal tract, unspecified Celiac disease 5570 5602 56031 56032 56081 56089 5609 56202 56212 56213 56723 5679 5693 56983 56985 56986 570 5720 5722 5723 57400 57401 57410 57411 57430 57431 57461 57471 57480 57481 5750 57510 57511 57512 5754 5761 5770 5771 5780 5781 5789 5790 141 Other and unspecified postsurgical nonabsorption Acute renal failure with lesion of tubular necrosis Acute renal failure with lesion of renal cortical necrosis Acute renal failure with other specified pathological lesion in kidney End stage renal disease Unspecified renal failure Hemorrhage into bladder wall Gross hematuria Peyronie's disease Diffuse cystic mastopathy Mastodynia Lump or mass in breast Oth signs/symptoms in breast Excessive or frequent menstruation Other disorder of menstruation and other abnormal bleeding from female genital tract Postmenopausal bleeding Lupus erythematosus Psoriatic arthropathy Oth psoriasis Circumscribed scleroderma Systemic lupus erythematosus Systemic sclerosis Sicca syndrome Unspecified diffuse connective tissue disease Pyogenic arthritis shoulder Pyogenic arthritis, lower leg Rheumatoid arthritis Rheumatoid arthritis visceral/syst Rheumatoid lung Uns inflammatory polyarthropathy Uns polyarthrit/arthropth site uns Effusion of joint shoulder Pain in joint, shoulder region Degenerat thoracic iv disc Oth syndromes affecting cervical Pain in thoracic spine Lumbago Thoracic or lumbosacral neuritis or radiculitis, unspecified Unspecified backache Other symptoms referable to back Polymyalgia rheumatica Other affections of shoulder region, not elsewhere classified 5793 5845 5846 5848 5856 586 5967 59971 60785 6101 61171 61172 61179 6262 6268 6271 6954 6960 6961 7010 7100 7101 7102 7109 71101 71106 7140 7142 71481 7149 71650 71901 71941 72251 7238 7241 7242 7244 7245 7248 725 7262 142 Necrotizing fasciitis Muscle weakness Rhabdomyolysis Rheumatism uns/fibrositis Uns myalgia/myositis Panniculitis of other sites Swelling of limb Acute osteomyelitis, site unspecified Acute osteomyelitis, lower leg Acute osteomyelitis, ankle and foot Acute osteomyelitis, other specified site Chronic osteomyelitis, pelvic region and thigh Chronic osteomyelitis, lower leg Chronic osteomyelitis, ankle and foot Chronic osteomyelitis, other specified sites Unspecified osteomyelitis, site unspecified Unspecified osteomyelitis, hand Unspecified osteomyelitis, pelvic region and thigh Unspecified osteomyelitis, other specified sites Pathologic fracture of humerus Pathological fracture vertebrae Pathologic fracture of neck of femur Pathologic fracture of other specified part of femur Pathologic fracture of other specified site Aseptic necrosis of bone, site unspecified Aseptic necrosis of head of humerus Aseptic necrosis of head and neck of femur Aseptic necrosis of other bone site Tietze's disease Stress fracture of femoral neck Kyphosis Scoliosis oth conditions Acquired deformity chest/rib Oth acquired deformity back/spine Nonallopathic lesion of thoracic region, not elsewhere classified Bulbus cordis anomalies and anomalies of cardiac septal closure, common truncus Complete transposition of great vessels Transposition of great vessels, double outlet right ventricle Corrected transposition of great vessels Tetralogy of Fallot Bulbus cordis anomalies and anomalies of cardiac septal closure, common ventricle Ventricular septal defect 72886 72887 72888 7290 7291 72939 72981 73000 73006 73007 73008 73015 73016 73017 73018 73020 73024 73025 73028 73311 73313 73314 73315 73319 73340 73341 73342 73349 7336 73396 73710 73743 7383 7385 7392 7450 74510 74511 74512 7452 7453 7454 143 Ostium secundum type atrial septal defect Unspecified type congenital endocardial cushion defect Ostium primum defect Other congenital endocardial cushion defect Unspecified congenital defect of septal closure Unspecified congenital pulmonary valve anomaly Congenital atresia of pulmonary valve Congenital stenosis of pulmonary valve Other congenital anomalies of pulmonary valve Congenital tricuspid atresia and stenosis Ebstein's anomaly Congenital stenosis of aortic valve Congenital insufficiency of aortic valve Congenital mitral stenosis Congenital mitral insufficiency Hypoplastic left heart syndrome Congenital subaortic stenosis Congenital coronary artery anomaly Congenital heart block Congenital malposition of heart and cardiac apex Other specified congenital anomaly of heart Unspecified congenital anomaly of heart Patent ductus arteriosus Coarctation of aorta (preductal) (postductal) Unspecified congenital anomaly of aorta Congenital atresia and stenosis of aorta Other congenital anomaly of aorta Congenital anomalies of pulmonary artery Congenital anomaly of the peripheral vascular system, unspecified site Congenital anomaly of cerebrovascular system Uns anomaly lung Congenital tracheoesophageal fistula, esophageal atresia and stenosis Anomalies diaphragm Down's syndrome Marfan's syndrome Other specified multiple congenital anomalies, so described Respiratory distress syndrome in newborn Coma Transient alteration of awareness Other alteration of consciousness Hallucinations Syncope and collapse Dizziness and giddiness 7455 74560 74561 74569 7459 74600 74601 74602 74609 7461 7462 7463 7464 7465 7466 7467 74681 74685 74686 74687 74689 7469 7470 74710 74720 74722 74729 7473 74760 74781 74860 7503 7566 7580 75982 75989 769 78001 78002 78009 7801 7802 7804 144 Fever Fever unspecified Hypothermia not associated with low environmental temperature Chronic fatigue syndrome Other malaise and fatigue Memory loss Generalized pain Altered mental status Transient paralysis of limb Localized superficial swelling Edema Cyanosis Spontaneous ecchymoses Anorexia Loss of weight Failure to thrive Polydipsia Adult failure to thrive Headache Swelling/mass/lump in head/neck Other speech disturbance Epistaxis Jaw pain Unspecified tachycardia Palpitations Undiagnosed cardiac murmurs Other abnormal heart sounds Gangrene Unspecified shock Cardiogenic shock Septic shock Other shock without mention of trauma Enlargement of lymph nodes Other symptoms involving cardiovascular system Unspecified respiratory abnormality Hyperventilation Orthopnea Apnea Cheyne-Stokes respiration Shortness of breath Tachypnea Wheezing Other dyspnea and respiratory abnormalities 7806 78060 78065 78071 78079 78093 78096 78097 7814 7822 7823 7825 7827 7830 78321 78341 7835 7837 7840 7842 7845 7847 78492 7850 7851 7852 7853 7854 78550 78551 78552 78559 7856 7859 78600 78601 78602 78603 78604 78605 78606 78607 78609 145 Stridor Cough Hemoptysis Hemoptysis unspecified Other hemoptysis Precordial pain Painful respiration Chest pain, other Swelling/mass/lump in chest Abnormal chest sounds Other symptoms involving respiratory system and chest Heartburn Dysphagia Abdominal pain, unspecified site Abdominal pain, right upper quadrant Abdominal pain, left upper quadrant Abdominal pain, right lower quadrant Abdominal pain, left lower quadrant Abdominal pain, periumbilic Abdominal pain, epigastric Abdominal pain, generalized Abdominal pain, other specified site Abdom/pelvic swelling unsp site Malignant ascites Other ascites Abdominal tenderness, unspecified site Abdominal tenderness, right upper quadrant Abdominal tenderness, right lower quadrant Abdominal tenderness, left lower quadrant Abdominal tenderness, epigastric Abdominal tenderness, generalized Abdominal tenderness, other specified site Oth abnormality red blood cells Elevated sedimentation rate Other abnormal glucose Nonspecific elevation of levels of transaminase or lactic acid dehydrogenase (LDH) Other nonspecific abnormal serum enzyme levels Other abnormal blood chemistry Bacteremia Abnormal arterial blood gases Elevated c-reactive protein Other nonspecific findings on examination of blood 7861 7862 7863 78630 78639 78651 78652 78659 7866 7867 7869 7871 7872 78900 78901 78902 78903 78904 78905 78906 78907 78909 78930 78951 78959 78960 78961 78963 78964 78966 78967 78969 79009 7901 79029 7904 7905 7906 7907 79091 79095 79099 146 Nonspecific abnormal findings on radiological and other examination of lung field Abnormal findings lung field other Nonspecific abnormal findings on radiological and other examination of other intrathoracic organs Unsp abnormal mammogram Mammographic microcalcification Ot abnormal radiolog exam breast Nonspecific abnormal electroencephalogram (EEG) Nonspecific abnormal results of pulmonary system function study Nonspecific abnormal unspecified cardiovascular function study Nonspecific abnormal electrocardiogram (ECG) (EKG) Other nonspecific abnormal cardiovascular system function study Nonspecific reaction tb test Other abnormal tumor markers Nonspecific abnormal toxicological findings Nonspecific low blood pressure reading Hypoxemia Respiratory arrest Symptoms involv emotional state Cachexia Closed fracture of base of skull without mention of intracranial injury, unspecified state Closed fracture of base of skull without mention of intracranial injury, no loss of consciousness Closed fracture of base of skull without mention of intracranial injury, loss of consciousness Closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, unspecified state of consciousness Closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, with no loss of consciousness Closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, with brief [less than one hour] loss of consciousness) Closed fracture of base of skull with subarachnoid, subdural, and extradural hemorrhage, with loss of consciousness of unspecified duration Fracture cervical vert unsp cl Fracture c2 vertebra closed Closed fracture of third cervical vertebra without mention of spinal cord injury Closed fracture of fourth cervical vertebra without mention of spinal cord injury Closed fracture of fifth cervical vertebra without mention of spinal cord injury Fracture c6 vertebra closed Closed fracture of seventh cervical vertebra without mention of spinal cord injury Closed fracture of multiple cervical vertebrae without mention of spinal cord injury Closed fracture of dorsal (thoracic) vertebra without mention of spinal cord injury Fracture lumbar vertebra close 7931 79319 7932 79380 79381 79389 79402 7942 79430 79431 79439 7955 79589 7960 7963 79902 7991 7992 7994 80100 80101 80106 80120 80121 80122 80126 80500 80502 80503 80504 80505 80506 80507 80508 8052 8054 147 Vertebral fracture unsp closed Closed fracture of C1-C4 level with unspecified spinal cord injury Closed fracture of C5-C7 level with unspecified spinal cord injury Closed fracture of T7-T12 level with unspecified spinal cord injury Closed fracture of lumbar spine with spinal cord injury Closed fracture of rib(s), unspecified Closed fracture of one rib Closed fracture of two ribs Closed fracture of three ribs Closed fracture of four ribs Closed fracture of five ribs Closed fracture of six ribs Closed fracture of seven ribs Closed fracture of eight or more ribs Closed fracture of multiple ribs, unspecified Closed fracture of sternum Flail chest Closed fracture of acetabulum Closed fracture of pubis Closed fracture of ilium Closed fracture of ischium Multiple closed pelvic fractures with disruption of pelvic circle Unspecified closed fracture of pelvis Unspecified part of closed fracture of clavicle Closed fracture of shaft of clavicle Closed fracture of acromial end of clavicle Closed fracture of unspecified part of scapula Closed fracture of glenoid cavity and neck of scapula Closed fracture of unspecified part of upper end of humerus Closed fracture of surgical neck of humerus Closed fracture of anatomical neck of humerus Closed fracture of greater tuberosity of humerus Other closed fractures of upper end of humerus Closed fracture of unspecified part of humerus Closed fracture of shaft of humerus Closed fracture of unspecified part of lower end of humerus Closed fracture of supracondylar humerus Closed fracture of unspecified condyle(s) of humerus Other closed fracture of lower end of humerus Ill-defined closed fractures of upper limb Closed fracture of unspecified intracapsular section of neck of femur Closed fracture of epiphysis (separation) (upper) of neck of femur Closed fracture of midcervical section of femur 8058 80600 80605 80625 8064 80700 80701 80702 80703 80704 80705 80706 80707 80708 80709 8072 8074 8080 8082 80841 80842 80843 8088 81000 81002 81003 81100 81103 81200 81201 81202 81203 81209 81220 81221 81240 81241 81244 81249 8180 82000 82001 82002 148 Closed fracture of base of neck of femur Other closed transcervical fracture of femur Closed fracture of unspecified trochanteric section of femur Closed fracture of intertrochanteric section of femur Closed fracture of subtrochanteric section of femur Open fracture of intertrochanteric section of femur Closed fracture of unspecified part of neck of femur Open fracture of unspecified part of neck of femur Closed fracture of unspecified part of femur Closed fracture of shaft of femur Closed fracture of unspecified part of lower end of femur Closed fracture of femoral condyle Closed supracondylar fracture of femur Other closed fracture of lower end of femur Open fracture of unspecified part of lower end of femur Open supracondylar fracture of femur Disloc shoulder unsp closed Closed anterior dislocation of humerus Sprain and strain of other specified sites of shoulder and upper arm Sprain and strain of unspecified site of shoulder and upper arm Thoracic sprain and strain Sprain and strain of unspecified site of back Sprain and strain of ribs Concussion, with loss of consciousness of 30 minutes or less Concussion with loss of consciousness of unspecified duration Unspecified concussion Cerebellar or brain stem contusion without mention of open intracranial wound, no loss of consciousness Other and unspecified cerebral laceration and contusion, without mention of open intracranial wound, unspecified state of consciousness Other and unspecified cerebral laceration and contusion, without mention of open intracranial wound, with no loss of consciousness Subarachnoid hemorrhage following injury, without mention of open intracranial wound, unspecified state of consciousness Subarachnoid hemorrhage following injury, without mention of open intracranial wound, no loss of consciousness Subarachnoid hemorrhage following injury, without mention of open intracranial wound, brief loss of consciousness Subarachnoid hemorrhage following injury, without mention of open intracranial wound, loss of consciousness Subdural hemorrhage following injury, without mention of open intracranial wound, unspecified state of consciousness Subdural hemorrhage following injury, without mention of open intracranial wound, no loss of consciousness Subdural hemorrhage following injury, without mention of open intracranial 82003 82009 82020 82021 82022 82031 8208 8209 82100 82101 82120 82121 82123 82129 82130 82133 83100 83101 8408 8409 8471 8479 8483 85011 8505 8509 85141 85180 85181 85200 85201 85202 85206 85220 85221 85222 149 wound, brief loss of consciousness Subdural hemorrhage following injury, without mention of open intracranial wound, without mention of open intracranial wound, with prolonged [more than 24 hours] loss of consciousness without return to pre-existing conscious level Subdural hemorrhage following injury, without mention of open intracranial wound, loss of consciousness Subdural hemorrhage following injury, without mention of open intracranial wound, unspecified state of consciousness Extradural hemorrhage following injury, without mention of open intracranial wound, unspecified state of consciousness Extradural hemorrhage following injury, without mention of open intracranial wound, no loss of consciousness Other and unspecified intracranial hemorrhage following injury, without mention of open intracranial wound, unspecified state of consciousness Other and unspecified intracranial hemorrhage following injury, without mention of open intracranial wound, with no loss of consciousness Other and unspecified intracranial hemorrhage following injury, without mention of open intracranial wound, with brief [less than one hour] loss of consciousness Other and unspecified intracranial hemorrhage following injury without mention of open intracranial wound, with prolonged [more than 24 hours] loss of consciousness without return to pre-existing conscious level Intracranial injury of other and unspecified nature, without mention of open intracranial wound, unspecified state of consciousness Intracranial injury of other and unspecified nature, without mention of open intracranial wound, with no loss of consciousness Intracranial injury of other and unspecified nature, without mention of open intracranial wound, with brief [less than one hour] loss of consciousness Intracranial injury of other and unspecified nature, without mention of open intracranial wound, with loss of consciousness of unspecified duration Traumatic pneumothorax without mention of open wound into thorax Traumatic hemothorax without mention of open wound into thorax Traumatic pneumohemothorax without mention of open wound into thorax Unspecified injury to heart without mention of open wound into thorax Heart contusion without mention of open wound into thorax Lung contusion without mention of open wound into thorax Injury to other specified intrathoracic organs without mention of open wound into cavity Injury to multiple and unspecified intrathoracic organs without mention of open wound into cavity Massive parenchymal disruption of spleen without mention of open wound into cavity Thoracic aorta injury Late effect of adverse effect of drug, medical or biological substance Contusion face/scalp/nck Contusion of breast Contusion of chest wall 85225 85226 85229 85240 85241 85300 85301 85302 85305 85400 85401 85402 85406 8600 8602 8604 86100 86101 86121 86229 8628 86504 9010 9095 920 9220 9221 150 Contusion of abdominal wall Contusion of unspecified part of trunk Contusion of shoulder region Contusion of uns site Foreign body in trachea Foreign body in main bronchus Foreign body in other specified parts of trachea, bronchus, and lung C1-C4 level with central cord syndrome Unspecified site of spinal cord injury without spinal bone injury Traumatic shock Uns head injury Injury face/neck Other injury of chest wall Other injury of abdomen Other injury other sites of trunk Injury, other and unspecified, shoulder and upper arm Injury, other and unspecified, other specified sites, including multiple Injury uns site Poisoning by adrenal cortical steroids Poisoning by insulins and antidiabetic agents Poisoning by antiallergic and antiemetic drugs Poisoning by antineoplastic and immunosuppressive drugs Poisoning by anticoagulants Poisoning by opium (alkaloids), unspecified Poisoning by heroin Poisoning by methadone Poisoning by opiates and related narcotics, other Poisoning by salicylates Poisoning by aromatic analgesics, not elsewhere classified Poisoning by propionic acid derivatives Poisoning by other specified analgesics and antipyretics Poisoning by unspecified analgesic and antipyretic Poisoning by hydantoin derivatives Poisoning by other and unspecified anticonvulsants Poisoning by barbiturates Poisoning by other sedatives and hypnotics Poisoning by unspecified sedative or hypnotic Poisoning by central nervous system muscle-tone depressants Poisoning by surface (topical) and infiltration anesthetics Poisoning by antidepressants Poisoning antidepressants unspec Poisoning SSRI Poisoning tricyclic antidepress 9222 9229 92300 9249 9340 9341 9348 95203 9529 9584 95901 95909 95911 95912 95919 9592 9598 9599 9620 9623 9630 9631 9642 96500 96501 96502 96509 9651 9654 96561 9658 9659 9661 9663 9670 9678 9679 9680 9685 9690 96900 96903 96905 151 Poisoning antidepressants other Poisoning by phenothiazine-based tranquilizers Poisoning by butyrophenone-based tranquilizers Poisoning by other antipsychotics, neuroleptics, and major tranquilizers Poisoning by benzodiazepine-based tranquilizers Poisoning by other tranquilizers Poisoning by psychodysleptics (hallucinogens) Poisoning by psychostimulants Poisoning by amphetamines Poisoning by other specified psychotropic agents Poisoning by opiate antagonists Poisoning by other specified central nervous system stimulants Poisoning by cocaine Poisoning by parasympathomimetics (cholinergics) Poisoning by parasympatholytics (anticholinergics and antimuscarinics) and spasmolytics Poisoning by sympathomimetics (adrenergics) Poisoning by sympatholytics (antiadrenergics) Poisoning by cardiac rhythm regulators Poisoning by cardiotonic glycosides and drugs of similar action Poisoning by antilipemic and antiarteriosclerotic drugs Poisoning by coronary vasodilators Poisoning by other antihypertensive agents Poisoning by other and unspecified agents primarily affecting the cardiovascular system Poisoning by other diuretics Poisoning by electrolytic, caloric, and water-balance agents Poisoning by skeletal muscle relaxants Poisoning by antitussives Poisoning by other specified drugs and medicinal substances Poisoning by unspecified drug or medicinal substance Toxic effect of ethyl alcohol Toxic effect of isopropyl alcohol Toxic effect of unspecified alcohol Toxic effect of other nonpetroleum-based solvents Toxic effect of caustic, unspecified Toxic effect of other specified metals Toxic effect of carbon monoxide Toxic effect of other specified gases, fumes, or vapors Toxic effect of unspecified gas, fume, or vapor Toxic effect of other pesticides, not elsewhere classified Toxic effect of venom Toxic effect of tobacco Toxic effect of other substances 96909 9691 9692 9693 9694 9695 9696 9697 96972 9698 9701 9708 97081 9710 9711 9712 9713 9720 9721 9722 9724 9726 9729 9744 9745 9752 9754 9778 9779 9800 9802 9809 9828 9839 9858 986 9878 9879 9894 9895 98984 98989 152 Toxic effect of unspecified substance, chiefly nonmedicinal as to source Effects of radiation, unspecified Effects of hypothermia Heat stroke and sunstroke Heat syncope Heat exhaustion, anhydrotic Heat exhaustion, unspecified Other specified heat effects Unspecified effects of heat and light Other and unspecified effects of high altitude Effects of lightning Drowning and nonfatal submersion Exhaustion due to excessive exertion Electrocution and nonfatal effects of electric current Other anaphylactic shock not elsewhere classified Angioneurotic edema not elsewhere classified Other and unspecified adverse effect of drug, medicinal and biological substance Unspecified adverse effect of unspecified drug, medicinal and biological substance Unspecified adverse effect of insulin Unspecified adverse effect of other drug, medicinal and biological substance Sepsis Severe sepsis Mechanical complication of unspecified cardiac device, implant, and graft Mechanical complication due to cardiac pacemaker (electrode) Mechanical complication due to heart valve prosthesis Mechanical complication due to coronary bypass graft Mechanical complication due to automatic implantable cardiac defibrillator Mechanical complication of cardiac device, implant, and graft, other Mechanical complication of other vascular device, implant, and graft Mechanical complication due to other tissue graft, not elsewhere classified Mechanical complication due to other implant and internal device, not elsewhere classified Infection and inflammatory reaction due to unspecified device, implant, and graft Infection and inflammatory reaction due to cardiac device, implant, and graft Infection and inflammatory reaction due to other vascular device, implant, and graft Infection and inflammatory reaction due to peritoneal dialysis catheter Other complications due to heart valve prosthesis Other complications due to other cardiac device, implant, and graft Other complications due to renal dialysis device, implant, and graft Other complications due to other vascular device, implant, and graft Complications of transplanted kidney Complications of transplanted liver Complications of transplanted heart 9899 990 9916 9920 9921 9923 9925 9928 9929 9932 9940 9941 9945 9948 9950 9951 9952 99520 99523 99529 99591 99592 99600 99601 99602 99603 99604 99609 9961 99652 99659 99660 99661 99662 99668 99671 99672 99673 99674 99681 99682 99683 153 Complications of transplanted lung Central nervous system complication Iatrogenic cerebrovascular infarction or hemorrhage Cardiac complications Respiratory complications Other respiratory complications Infection (chronic) of amputation stump Other late amputation stump complication Vascular complications of other vessels Postoperative shock, not elsewhere classified Hemorrhage complicating a procedure Hematoma complication proced Accidental puncture or laceration during procedure Other postop infection Cataract fragments in eye following surgery Complications of medical care, NEC, infection due to central venous catheter Bloodstream infection central line Other infusion and transfusion reaction Traffic acc nos-pers nos Acc cut/hem in surgery Abn react-surg proc nec Fall from other slipping, tripping, or stumbling Fall nec Unspecified fall Accident nos Antineoplastic and immunosuppressive drugs causing adverse effect in therapeutic use Cardiac rhythm regulators causing adverse effect in therapeutic use Adv eff antilipemics Contact/exposure to tb Asymptomatic human immunodeficiency virus (HIV) infection status Personal history of malignant neoplasm of large intestine Personal history of malignant neoplasm of rectum, rectosigmoid junction, and anus Personal history of malignant neoplasm of bronchus and lung Personal history of malignant neoplasm of breast Personal history of malignant neoplasm of ovary Personal history of malignant neoplasm of prostate Personal history of malignant neoplasm of bladder History other malignancy skin History tuberculosis Personal history of sudden cardiac arrest Personal history of transient ischemic attack [TIA], and cerebral infarction without resid Personal history of other diseases of circulatory system 99684 99701 99702 9971 9973 99739 99762 99769 99779 9980 99811 99812 9982 99859 99882 99931 99932 9998 E8199 E8700 E8788 E8859 E8888 E8889 E9289 E9331 E9420 E9422 V011 V08 V1005 V1006 V1011 V103 V1043 V1046 V1051 V1083 V1201 V1253 V1254 V1259 154 History pneumonia Personal history of surgery to heart and great vessels, presenting hazards to health History exposure to asbestos Personal history of fall Other mental problems Kidney replaced by transplant Heart replaced by transplant Heart valve replaced by transplant Lung replaced by transplant Liver replaced by transplant Bone marrow replaced by transplant Organ or tissue replaced by other means, Heart assist device Heart valve replaced by other means Blood vessel replaced by other means Unspecified cardiac device in situ Cardiac pacemaker in situ Automatic implantable cardiac defibrillator in situ Other specified cardiac device in situ Renal dialysis status Renal dialysis status Postprocedural aortocoronary bypass status Postprocedural percutaneous transluminal coronary angioplasty status Other cardiorespiratory problems Fitting and adjustment of cardiac pacemaker Fitting and adjustment of automatic implantable cardiac defibrillator Fitting and adjustment of other cardiac device Removal int fixation device Attention to tracheostomy Encounter for extracorporeal dialysis Fitting and adjustment of extracorporeal dialysis catheter Fitting and adjustment of peritoneal dialysis catheter Radiotherapy Encounter for antineoplastic chemotherapy Encounter for antineoplastic immunotherapy Aftercare following surgery for neoplasm Aftercare following organ transplant Encounter for long-term (current) use of other medications Fitting and adjustment of vascular catheter Encounter for therapeutic drug monitoring Kidney donor Suicidal ideation Chemotherapy follow-up examination Follow-up examination following completed treatment with high-risk medications, V1261 V151 V1584 V1588 V402 V420 V421 V422 V426 V427 V4281 V4321 V433 V434 V4500 V4501 V4502 V4509 V451 V4511 V4581 V4582 V472 V5331 V5332 V5339 V5401 V550 V560 V561 V562 V580 V5811 V5812 V5842 V5844 V5869 V5881 V5883 V594 V6284 V672 V6751 155 not elsewhere classifed Issue of repeat prescriptions Other and unspecified general psychiatric examination Examination of participant in clinical trial Observation of other suspected mental condition Observation for suspected malignant neoplasm Observ suspected tb Observ following oth accident Observation for suspected cardiovascular disease Screening for pulmonary tb Screening mammogram ot Special screening mal neo ot Screening for defic anemia ot V681 V702 V707 V7109 V711 V712 V714 V717 V741 V7612 V7649 V781 ICD-9 Codes for Excluding Chest X-Rays Chest x-rays were excluded from the analysis if the associated primary, secondary, tertiary, or quaternary diagnosis involved: (i) fever; (ii) fatigue or malaise; (iii) vertebral or spine symptoms; (iv) pneumonia; (v) cancer; (vi) chest pain; (vii) acute respiratory symptoms; (viii) trauma or hemorrhage; (ix) cardiac disease; (x) toxicity; (xi) drug monitoring; (xii) end stage or acute renal failure and dialysis, but not chronic early stage renal insufficiency; (xiii) abdominal pain and conditions associated with abdominal pain; (xiv) asbestosis; (xv) esophageal symptoms and disease; (xvi) acute central nervous system disease; (xvi) shoulder or limb pain; (xvii) weight loss or cachexia. Label Pulmonary diseases other mycobact Streptococcal septicemia Meth susc staph aureus septicemia Escherichia coli septicemia Uns septicemia Mssa infection Mrsa infection Human immunodeficiency virus dis Unspecified viral infection Lyme disease Sarcoidosis Uns malignant neoplasm colon Malignant neoplasm rectum Malig neo pancreas part uns Malig neo upper lobe bronchus/lung Malig neo oth parts bronchus/lung Uns malignant neo bronchus/lung Melanoma skin site unspecified Code 0310 0380 03811 03842 0389 04111 04112 042 07999 08881 135 1539 1541 1579 1623 1628 1629 1729 156 Oth malig neo ear skin external Malig neo skin oth uns parts face Oth malignant neo scalp/skin neck Oth malig neo skin l limb inc hip Oth malignant neo skin site uns Malignant neoplasm fem breast uoq Malig neo other sites fem breast Uns malignant neoplasm breast Malignant neoplasm ovary Malignant neo prostate Uns malignant neoplasm bladder Malig neo kidney ex renal pelvis Malignant neo thyroid gland Sec malignant neoplasm lung Sec malig neo bone/bone marrow Oth malig neo wo specification site Oth lymphomas uns extranod Multiple myeloma wo remission Chronic lymphoid leukemia wo remis Benign neoplasm bronchus/lung Benign neoplasm cerebral meninges Ca in situ breast Ca in situ prostate Uncert behavior neo intestine Uncert behavior neo lung Uncert behavior neo prostate Uncert behavior neo bladder Uncert behavior neo kidney Uncert behavior neo skin Uncert behavior neo breast Polycythemia vera Essential thrombocythemia Lo gr myelodysplastic synd lesions Myelodysplastic syndrome unspec Respiratory unsp behavior neo Bone/skin unsp behavior neo Bladder unsp behavior neo Ot gu unsp behavior neo Brain unsp behavior neo Endonerv unsp behavior neo Unsp behavior neo Acute thyroiditis Diabetes ketoacidosis type ii 1732 1733 1734 1737 1739 1744 1748 1749 1830 185 1889 1890 193 1970 1985 1991 20280 20300 20410 2123 2252 2330 2334 2352 2357 2365 2367 23691 2382 2383 2384 23871 23872 23875 2391 2392 2394 2395 2396 2397 2399 2450 25010 157 Diabetes hypersmolarity type ii Glucocorticoid deficiency Uns protein calorie malnutrition Disturb sulphur amino acid metabol Monoclonal paraproteinemia Disorders of iron metabolism Disorders magnesium metabolism Disorders phosphorus metabolism Uns disorder calcium metabolism Hypocalcemia Hypercalcemia Oth disorders calcium metabolism Hyperosmolality/or hypernatremia Hyposmolality/or hyponatremia Acidosis Volume depletion unspecified Dehydration Fluid overload Hyperpotassemia Hypopotassemia Electrolyte/fluid disorders oth Autoimmune disease other Iron deficiency anemia blood loss Iron def anemia inadeq iron intake Other iron deficiency anemias Uns iron deficiency anemia Pernicious anemia Oth vitamin b12 deficiency anemia Folate deficiency anemia Other megaloblastic anemias oth Anemia w ot nutritional deficiency Uns deficiency anemia Uns acquired hemolytic anemia Pancytopenia Other aplastic anemias Sideroblastic anemia Acute posthemorrhagic anemia Anemia chronic kidney disease Anemia of other chronic disease Other specified anemias Anemia unspecified Intrin circ anticoag hemorr dis Defibrination syndrome 25020 25541 2639 2704 2731 2750 2752 2753 27540 27541 27542 27549 2760 2761 2762 27650 27651 2766 2767 2768 2769 2794 2800 2801 2808 2809 2810 2811 2812 2813 2818 2819 2839 2841 2848 2850 2851 28521 28529 2858 2859 2865 2866 158 Oth nonthrombocytopenic purpuras Primary thrombocytopenia unspec Immune thrombocytopenic purpura Uns thrombocytopenia Uns hemorrhagic conditions Neutropenia unspecified Functional disord neutrophils Leukocytopenia unspecified Leukocytosis unspecified Other disease white blood cells Polycythemia secondary Ot dis blood/blood forming organs Uns dis blood/blood forming organs Delirium in other conditions Uns schizophrenia Depressive type psychosis Maj depress dis recurr epi uns Maj depress dis recur epi sev Bipolar i disorder unspecified Bipolar disorder unspecified Unspecified psychosis Anxiety state unspecified Panic disorder wo agoraphobia Generalized anxiety disorder Dysthymic disorder Psychosex dysfunc inhibited excite Oth/uns alcohol dependence uns Opioid type dependence uns Opioid type dependence continuous Unspec drug dependence uns Alcohol abuse unspec Oth mixed/uns drug abuse uns Adjustment disorder mixed Personality chg due to oth cond Depressive disorder other Obstructive hydrocephalus Other acute postoperative pain Multiple sclerosis Encephalopathy unspecified Metabolic encephalopathy Other visual disturbances Uns peripheral vertigo Benign paroxysmal position vertigo 2872 28730 28731 2875 2879 28800 2881 28850 28860 2888 2890 28989 2899 2930 29590 29620 29630 29633 2967 29680 2989 30000 30001 30002 3004 30272 30390 30400 30401 30490 30500 30590 30928 3101 311 3314 33818 340 34830 34831 3688 38610 38611 159 Rheumatic mitral insufficiency Mitral stenosis w insufficiency Oth/uns mitral valve diseases Rheumatic aortic stenosis Mitral valve sten aortic valve sten Mitral valve insuff aortic v sten Mitral valve insuff aortic v insuf Uns mitral/aortic valve diseases Diseases tricuspid valve Malignant essential hypertension Malig hyperten heart dis unspec Benign hyperten heart dis unspec Benign hyp heart dis w ht failure Hypertensive heart dis unspec Hyperten heart dis w ht failure Mal kid hyper w ckd stage i-iv Uns kid hyper w ckd stage v-esrd Ami oth anterior uns eoc Ami subendocardial initial eoc Ami uns site uns eoc Intermediate coronary syndrome Coronary occlusion wo infarction Oth forms ischemic heart disease Old myocardial infarction Angina decubitus Prinzmetal angina Oth/uns angina pectoris Coronary athrscler uns vessel Atheroscler native coronary art Atherosclerosis auto vein graft Coronary atheroscl artery bpg Coronary atheroscler uns graft Aneurysm of heart (wall) Other forms chronic ischemic ht dis Uns chronic ischemic heart disease Iatrogenic pulmonary embolism Oth pulmonary embolism/infarction Primary pulmonary hypertension Oth chronic pulmonary heart disease Uns chronic pulmonary heart disease Acute/subacute bacterial endocard Uns disease pericardium Mitral valve disorders 3941 3942 3949 3950 3960 3962 3963 3969 3970 4010 40200 40210 40211 40290 40291 40300 40391 41010 41071 41090 4111 41181 41189 412 4130 4131 4139 41400 41401 41402 41404 41405 41410 4148 4149 41511 41519 4160 4168 4169 4210 4239 4240 160 Aortic valve disorders Tricuspid valve disorders nonrheum Pulmonary valve disorders Endocarditis uns valve/uns cause Hypertrophic cardiomyopathy Oth primary cardiomyopathies Uns secondary cardiomyopathy Atrioventricular block complete Uns atrioventricular block First degree atrioventricular block Mobitz ii atrioventricular block Oth second degree av block Left bundle branch hemiblock Oth left bundle branch block Right bundle branch block Uns bundle branch block Right bbb/left anterior fasc block Other bilateral bundle branch block Other conduction disorders Paroxysmal supravent tachycardia Paroxysmal ventricular tachycardia Uns paroxysmal tachycardia Atrial fibrillation Atrial flutter Cardiac arrest Uns premature beats Supraventricular premature beats Oth premature beats Sinoatrial node dysfunction Other cardiac dysrhythmias Uns cardiac dysrhythmia Congestive heart failure unspec Left heart failure Unspec systolic heart failure Acute systolic heart failure Chronic systolic heart failure Unspec diastolic heart failure Chronic diastolic heart failure Ac/chron diastolic heart failure Uns heart failure Myocardial degeneration Cardiovascular disease unspecified Cardiomegaly 4241 4242 4243 42490 4251 4254 4259 4260 42610 42611 42612 42613 4262 4263 4264 42650 42652 42653 42689 4270 4271 4272 42731 42732 4275 42760 42761 42769 42781 42789 4279 4280 4281 42820 42821 42822 42830 42832 42833 4289 4291 4292 4293 161 Other ill-defined heart diseases Heart disease unspecified Subarachnoid hemorrhage Intracerebral hemorrhage Subdural hemorrhage Occlusion carotid artery wo infarct Occlusion carotid artery w infarct Occlusion vertebral artery wo infar Occlus mult bilat precer art wo inf Uns cer art occlusion wo cer infarc Uns cer artery occlusion w cer inf Vertebral artery syndrome Other transient cerebral ischemias Uns transient cerebral ischemia Acute ill defined cv disease Cerebral atherosclerosis Oth generalized ischemic cv disease Cerebral aneurysm nonruptured Uns cerebrovascular disease Vertigo Uns late effects cv disease Atherosclerosis aorta Atherosclerosis renal artery Uns atherosclerosis extremities Atheroscler ext w intermittent cl Atherosclerosis ext w rest pain Generalized/uns atherosclerosis Thoracic aortic aneurysm worupture Abdominal aortic aneurysm worupture Aortic aneurysm uns site Raynaud's syndrome Embolism arteries lower extremity Wegener's granulomatosis Giant cell arteritis Stricture artery Other disorders arteries/arterioles Uns disorders arteries/arterioles Embolism/thrombosis inf vena cava Ac emb/throm uns deep ves lower ext Embolism/thrombosis uns site Orthostatic hypotension Hypotension unspecified Hemorrhage unspecified 42989 4299 430 431 4321 43310 43311 43320 43330 43490 43491 4351 4358 4359 436 4370 4371 4373 4379 43885 4389 4400 4401 44020 44021 44022 4409 4412 4414 4419 4430 44422 4464 4465 4471 4478 4479 4532 45340 4539 4580 4589 4590 162 Other disorders circulatory system Acute pharyngitis Acute upper resp infect oth sites Acute upper resp infections uns Acute bronchitis Pneumonia adenovirus Pneumonia respiratory syncy virus Uns viral pneumonia Pneumococcal pneumonia Pneumonia other bacteria Uns bacterial pneumonia Bronchopneumonia organism unspec Pneumonia organism unspecified Influenza with pneumonia Influenza w oth respiratory manif Bronchitis unspecified Simple chronic bronchitis Obstruct chron bronchitis wo exac Obstruct chron bronchitis w exac Obst chr bronchitis w ac bronchitis Emphysematous bleb Other emphysema Extrinsic asthma unspecified Ex asthma w exacerbation Intrinsic asthma unspecified Chron obstructive asthma unspecif Chronic obst asthma w status asthm Chronic obstruct asthma w exacer Asthma unspecified Uns asthma w status asthmaticus Asthma unspec w exacerbation Bronchiectasis wo acute exacerb Bronchiectasis w acute exacerb Chronic airway obstruction other Asbestosis Pneumonitis inhalation food Pleurisy woeffusion/current tb Other effusion not tuberculous Unspecif pleural effusion Iatrogenic pneumothorax Other pneumothorax and air leak Pulmonary congestion/hypostasis Postinflammatory pulmonary fibrosis 45989 462 4658 4659 4660 4800 4801 4809 481 48289 4829 485 486 4870 4871 490 4910 49120 49121 49122 4920 4928 49300 49302 49310 49320 49321 49322 49390 49391 49392 4940 4941 496 501 5070 5110 5118 5119 5121 5128 514 515 163 Idiopathic interstitial pneumonia Other alveolar pneumonopathy Uns alveolar pneumonopathy Pulmonary collapse Pulmonary eosinophilia Uns acute edema lung Pulmonary insuffic trauma surgery Respiratory failure Oth pulmonary insufficiency other Oth diseases lung other Acute bronchospasm Oth diseases trachea/bronchus Disorders diaphragm Oth diseases respiratory system Uns disease respiratory system Uns esophagitis Reflux esophagitis Oth esophagitis Esophageal reflux Acute gastritis wohemorrhage Diaphragmatic hernia Uns ulcerative colitis Hemorrhage rectum/anus Acute pancreatitis Hematemesis Uns hemorr gastrointestinal tract Celiac disease Uns acute kidney failure End stage renal disease Diffuse cystic mastopathy Mastodynia Lump or mass in breast Oth signs/symptoms in breast Postmenopausal bleeding Lupus erythematosus Psoriatic arthropathy Oth psoriasis Systemic lupus erythematosus Systemic sclerosis Sicca syndrome Uns diffuse connect tissue disease Pyogenic arthritis shoulder Rheumatoid arthritis 5163 5168 5169 5180 5183 5184 5185 51881 51882 51889 51911 51919 5194 5198 5199 53010 53011 53019 53081 53500 5533 5569 5693 5770 5780 5789 5790 5849 5856 6101 61171 61172 61179 6271 6954 6960 6961 7100 7101 7102 7109 71101 7140 164 Rheumatoid arthritis visceral/syst Uns inflammatory polyarthropathy Uns polyarthrit/arthropth site uns Effusion of joint shoulder Pain in joint site uns Pain in joint shoulder Degenerat thoracic iv disc Oth syndromes affecting cervical Pain in thoracic spine Uns thoracic/lumb neuritis/radicul Backache unspecified Oth symptoms referable to back Polymyalgia rheumatica Oth affections shoulder region Muscle weakness Rhabdomyolysis Rheumatism uns/fibrositis Uns myalgia/myositis Pain in limb Swelling limb Acute osteomyelitis oth sites Uns osteomyelitis site uns Uns osteomyelitis oth sites Pathological fracture vertebrae Kyphosis Scoliosis oth conditions Acquired deformity chest/rib Oth acquired deformity back/spine Ostium secundum at/septal defect Congenital mitral insufficiency Coronary artery anomaly Other anomalies heart Uns anomaly heart Atresia/stenosis aorta Oth anomalies aorta Uns anomaly lung Anomalies diaphragm Transient alteration awareness Oth alteration consciousness Syncope and collapse Dizziness and giddiness Fever Fever unspecified 7142 7149 71650 71901 71940 71941 72251 7238 7241 7244 7245 7248 725 7262 72887 72888 7290 7291 7295 72981 73008 73020 73028 73313 73710 73743 7383 7385 7455 7466 74685 74689 7469 74722 74729 74860 7566 78002 78009 7802 7804 7806 78060 165 Chronic fatigue syndrome Other malaise and fatigue Memory loss Altered mental status Localized superficial swelling Edema Spontaneous ecchymoses Loss of weight Headache Swelling/mass/lump in head/neck Epistaxis Tachycardia unspecified Palpitations Undiagnosed cardiac murmurs Other abnormal heart sounds Other shock without trauma Enlargement of lymph nodes Other cardiovascular symptoms Respiratory abnormality unspec Hyperventilation Orthopnea Apnea Shortness breath Tachypnea Wheezing Respiratory abnormality ot Cough Hemoptysis Hemoptysis unspecified Unspec chest pain Precordial pain Painful respiration Other chest pain Swelling/mass/lump in chest Abnormal chest sounds Other respiratory symptoms Dysphagia Dysphagia unspecified Abdominal pain uns site Abdom pain r upper quad Abdom pain l upper quad Abdom pain r lower quad Abdominal pain periumbilic 78071 78079 78093 78097 7822 7823 7827 78321 7840 7842 7847 7850 7851 7852 7853 78559 7856 7859 78600 78601 78602 78603 78605 78606 78607 78609 7862 7863 78630 78650 78651 78652 78659 7866 7867 7869 7872 78720 78900 78901 78902 78903 78905 166 Abdominal pain epigastric Abdominal pain generalized Abdominal pain other site Abdom/pelvic swelling unsp site Other ascites Oth abnormality red blood cells Elevated sedimentation rate Other abnormal glucose Oth abnormal blood chemistry Bacteremia Abnormal arterial blood gases Elevated c-reactive protein Abnormal findings lung field Abnormal findings lung field other Abnormal fd intrathor org ot Unsp abnormal mammogram Mammographic microcalcification Ot abnormal radiolog exam breast Abnormal pulmonary func study Abnormal cardiovasc study unspec Abnorm electrocardiogram Abnormal cardiovasc study ot Nonspecific reaction tb test Other abnormal tumor markers Hypoxemia Symptoms involv emotional state Fracture cervical vert unsp cl Fracture c2 vertebra closed Fracture c3 vertebra closed Fracture c4 vertebra closed Fracture c5 vertebra closed Fracture c6 vertebra closed Fracture c7 vertebra closed Fracture mult cervical vert cl Fracture dorsal vertebra close Fracture lumbar vertebra close Vertebral fracture unsp closed C1-c4 fracture clos/cord inj unsp C5-c7 fracture clos/cord inj unsp Closed fracture rib(s) uns Closed fracture one rib Closed fracture two ribs Closed fracture multiple ribs uns 78906 78907 78909 78930 78959 79009 7901 79029 7906 7907 79091 79095 7931 79319 7932 79380 79381 79389 7942 79430 79431 79439 7955 79589 79902 7992 80500 80502 80503 80504 80505 80506 80507 80508 8052 8054 8058 80600 80605 80700 80701 80702 80709 167 Closed fracture uns part clavicle Fracture gr tuberos humerus closed Disloc shoulder unsp closed Traum subarachnoid hemorrage Traumatic subdural hemorrage Traumatic brain hemorrage ot Intracranial injury ot Traumatic pneumothorax wo open wd Lung contusion wo open wound Contusion face/scalp/nck Contusion of chest wall Contusion of shoulder region Contusion of uns site C1-c4 inj w central cord syndrome Uns head injury Injury face/neck Other injury of chest wall Other injury of abdomen Other injury other sites of trunk Oth/uns injury shoulder/upper arm Injury other sites inc mult sites Injury uns site Poisoning anticoagulants Other/unspec adverse effect drug Unspec adverse effect drug Other adverse effect drug Sepsis Malfunction cardiac pacemake Malfunction vasc device/graf Complication renal dialy dev Complication heart transplant Complication lung transplant Surg complication heart Hematoma complication proced Accidental op laceration Other postop infection Traffic acc nos-pers nos Acc cut/hem in surgery Abn react-surg proc nec Fall from slipping nec Fall nec Fall nos Accident nos 81000 81203 83100 85200 85220 85300 85400 8600 86121 920 9221 92300 9249 95203 95901 95909 95911 95912 95919 9592 9598 9599 9642 9952 99520 99529 99591 99601 9961 99673 99683 99684 9971 99812 9982 99859 E8199 E8700 E8788 E8859 E8888 E8889 E9289 168 Adv eff antineoplastic Adv eff antilipemics Contact/exposure to tb History malignancy large intestine History malignancy bronchus/lung History malignancy breast History malignancy prostate History malignancy bladder History other malignancy skin History tuberculosis History unsp circulatory disease History venous thrombosis/embolism History tia/stroke wo residual def History pneumonia History surgery heart/great vessels History exposure to asbestos History exposure hazard body fluid History of fall Kidney replaced by transplant Heart replaced by transplant Lung replaced by transplant Liver replaced by transplant Heart valve replaced by oth means Cardiac pacemaker in situ Implantable cardiac defib in situ Renal dialysis status Renal dialysis status Aortocoronary bypass status Perc trans cor angioplasty status Other cardiorespiratory problems Fitting/adjust pacemaker Fitting/adjust impl defibrillator Removal int fixation device Encounter for extracorp dialysis Antineoplastic chemotherapy Aftercare follow organ transplant Encounter long term use oth drugs Fitting/adjust vascular catheter Fitting/adjust nonvascular cath Enctr therap drug monitoring Follow-up after tx high risk drug Observ suspected malignant neoplasm Observ suspected tb E9331 E9422 V011 V1005 V1011 V103 V1046 V1051 V1083 V1201 V1250 V1251 V1254 V1261 V151 V1584 V1585 V1588 V420 V421 V426 V427 V433 V4501 V4502 V451 V4511 V4581 V4582 V472 V5331 V5332 V5401 V560 V5811 V5844 V5869 V5881 V5882 V5883 V6751 V711 V712 169 Observ following oth accident Observ suspected cardiovascular dis Screening for pulmonary tb Screening mammogram ot Special screening mal neo ot Screening for defic anemia ot V714 V717 V741 V7612 V7649 V781 170 Don't perform preoperative cardiac tests for low-risk, non-cardiac surgeries Choosing Wisely Guidelines American College of Cardiology American College of Physicians American College of Radiology American College of Surgeons American Society of Anesthesiologists Don’t perform stress cardiac imaging or advanced non-invasive imaging as a pre-operative assessment in patients scheduled to undergo low-risk non-cardiac surgery. Non-invasive testing is not useful for patients undergoing low-risk non-cardiac surgery (e.g., cataract removal). These types of tests do not change the patient’s clinical management or outcomes and will result in increased costs. Don’t obtain preoperative chest radiography in the absence of a clinical suspicion for intrathoracic pathology. In the absence of cardiopulmonary symptoms, preoperative chest radiography rarely provides any meaningful changes in management or improved patient outcomes. Avoid admission or preoperative chest x-rays for ambulatory patients with unremarkable history and physical exam. Performing routine admission or preoperative chest x-rays is not recommended for ambulatory patients without specific reasons suggested by the history and/or physical examination findings. Only 2 percent of such images lead to a change in management. Obtaining a chest radiograph is reasonable if acute cardiopulmonary disease is suspected or there is a history of chronic stable cardiopulmonary disease in a patient older than age 70 who has not had chest radiography within six months Avoid admission or preoperative chest X rays for ambulatory patients with unremarkable history and physical exam. Performing routine admission or preoperative chest X rays is not recommended for ambulatory patients without specific reasons suggested by the history and/or physical examination findings. Only 2 percent of such images lead to a change in management. Obtaining a chest radiograph is reasonable if acute cardiopulmonary disease is suspected or there is a history of chronic stable cardiopulmonary diseases in patients older than age 70 who have not had chest radiography within six months. Don’t obtain baseline diagnostic cardiac testing (transthoracic/esophageal echocardiography – TTE/TEE) or cardiac stress testing in asymptomatic stable patients with known cardiac disease (e.g., CAD, valvular disease) undergoing low or moderate risk noncardiac surgery. Advances in cardiovascular medical management, particularly the introduction of perioperative beta-blockade and improvements in surgical and anesthetic techniques, have significantly decreased operative morbidity and mortality rates in noncardiac surgery. Surgical outcomes continue to improve causing the mortality rate of major surgeries to be low and the need for revascularization minimal. Consequently, the role of preoperative cardiac stress testing has been reduced to the identification of extremely high-risk patients, for instance, those with significant left 171 American Society of Echocardiography American Society of Nuclear Cardiology Society of Cardiovascular Computed Tomography Society of General Internal Medicine Society of Thoracic Surgeons main disease for which preoperative revascularization would be beneficial regardless of the impending procedure. In other words, testing may be appropriate if the results would change management prior to surgery, could change the decision of the patient to undergo surgery, or change the type of procedure that the surgeon will perform. Avoid echocardiograms for preoperative/perioperative assessment of patients with no history or symptoms of heart disease. Perioperative echocardiography is used to clarify signs or symptoms of cardiovascular disease, or to investigate abnormal heart tests. Resting left ventricular (LV) function is not a consistent predictor of perioperative ischemic events; even reduced LV systolic function has poor predictive value for perioperative cardiac events. Don’t perform cardiac imaging as a preoperative assessment in patients scheduled to undergo low- or intermediate-risk non-cardiac surgery. Non-invasive testing is not useful for patients undergoing low-risk non-cardiac surgery or with no cardiac symptoms or clinical risk factors undergoing intermediate-risk non-cardiac surgery. These types of testing do not change the patient’s clinical management or outcomes and will result in increased costs. Therefore, it is not appropriate to perform cardiac imaging procedures for non-cardiac surgery risk assessment in patients with no cardiac symptoms, clinical risk factors or who have moderate to good functional capacity. Don’t order coronary artery calcium scoring for preoperative evaluation for any surgery, irrespective of patient risk. No evidence exists to support the diagnostic or prognostic potential of coronary artery calcium scoring in individuals in the preoperative setting. This practice may add costs and confound professional guideline-based evaluations Don’t perform routine pre-operative testing before low-risk surgical procedures. Pre-operative assessment is expected before all surgical procedures. This assessment includes an appropriately directed and sufficiently comprehensive history and physical examination, and, in some cases, properly includes laboratory and other testing to help direct management and assess surgical risk. However, pre-operative testing for low-risk surgical procedures (such as cataract extraction) results in unnecessary delays and adds to significant avoidable costs and should be eliminated. Patients who have no cardiac history and good functional status do not require preoperative stress testing prior to non-cardiac thoracic surgery. Functional status has been shown to be reliable for prediction of perioperative and long-term cardiac events. In highly functional asymptomatic patients, management is rarely changed by preoperative stress testing. It is therefore appropriate to proceed with the planned surgery without it. Unnecessary stress testing can be harmful because it increases the cost of care and delays treatment without altering surgical or perioperative management in a 172 Society for Vascular Medicine meaningful way. Furthermore, low-risk patients who undergo preoperative stress testing are more likely to obtain additional invasive testing with risks of complications. Cardiac complications are significant contributors to morbidity and mortality after noncardiac thoracic surgery, and it is important to identify patients preoperatively who are at risk for these complications. The most valuable tools in this endeavor include a thorough history, physical exam and resting EKG. Cardiac stress testing can be an important adjunct in this evaluation, but it should only be used when clinically indicated. Avoid cardiovascular testing for patients undergoing low-risk surgery. Pre-operative stress testing does not alter therapy or decision-making in patients facing low-risk surgery. Methods We calculated the percent of Medicare beneficiaries over age 65 who received a non-indicated electrocardiogram, cardiovascular stress test (including stress imaging), echocardiogram, chest xray, or advanced cardiac imaging (CT, MRI, PET) in the 30 days before low-risk, non-cardiac in each calendar year 2006-11. We then created a weighted average of testing prevalence for the interval 2006-11. We identified low-risk, non-cardiac surgeries using the following BETOS codes: P1A (Major Procedure – Breast), P1D (Major Procedure – TURP), P1F (Major Procedure - Explor/Decompr/ExcisDisc), P4A (Eye Procedures - Corneal Transplant), P5C (Ambulatory Procedures - Inguinal Hernia Repair), P5D (Ambulatory Procedures – Lithotripsy), P8A (Endoscopy – Arthroscopy), P8G (Endoscopy - Lararoscopic Cholecystectomy). We required enrollment in fee-for-service Medicare Parts A and B for at least 11 months during the calendar year. We did not count testing events if diagnosis codes in any of the first four fields on a claim involved cardiac disease, cardiac-related symptoms, or any conditions that might justify the test (e.g., respiratory conditions, cancer), and we excluded beneficiaries who were admitted in the 30 days before the surgery. References Physician Quality Reporting System (PQRS) Measure Specifications Manual for Claims and Registry Reporting of Individual Measures. Centers for Medicare and Medicaid Services. 2014. CPT Codes for Identifying Cardiac Tests (Advanced Imaging, Cardiac Stress Tests, Echocardiograms, and Electrocardiograms) See codes applied to cardiac testing measure (pp. 7). CPT Codes for Identifying Chest X-Rays See codes applied to preoperative cardiac testing (cataract surgery) (pp. 77). ICD-9 Codes for Excluding Cardiac Tests (Advanced Imaging, Cardiac Stress Tests, Chest XRays, Echocardiograms, and Electrocardiograms) 173 See codes applied to preoperative cardiac testing (cataract surgery) (pp. 77). 174 Don’t perform population based screening for 25-OH-Vitamin D deficiency Choosing Wisely Guidelines American Society for Clinical Pathology Endocrine Society and American Association of Clinical Endocrinologists Don’t perform population based screening for 25-OH-Vitamin D deficiency. Vitamin D deficiency is common in many populations, particularly in patients at higher latitudes, during winter months and in those with limited sun exposure. Over the counter Vitamin D supplements and increased summer sun exposure are sufficient for most otherwise healthy patients. Laboratory testing is appropriate in higher risk patients when results will be used to institute more aggressive therapy (e.g., osteoporosis, chronic kidney disease, malabsorption, some infections, obese individuals). Don’t routinely measure 1,25-dihydroxyvitamin D unless the patient has hypercalcemia or decreased kidney function. Many practitioners become confused when ordering a vitamin D test. Because 1,25dihydroxyvitamin D is the active form of vitamin D, many practitioners think that measuring 1,25-dihydroxyvitamin D is an accurate means to estimate vitamin D stores and test for vitamin D deficiency, which is incorrect. Current Endocrine Society guidelines recommend screening for vitamin D deficiency in individuals at risk for deficiency. Serum levels of 1,25-dihyroxyvitamin D have little or no relationship to vitamin D stores but rather are regulated primarily by parathyroid hormone levels, which in turn are regulated by calcium and/or vitamin D. In vitamin D deficiency, 1,25dihydroxyvitamin D levels go up, not down. Unregulated production of 1,25-dihydroxyvitamin D (i.e., sarcoidosis, granulomatous diseases) is an uncommon cause of hypercalcemia; this should be suspected if blood calcium levels are high and parathyroid hormone levels are low and confirmed by measurement of 1,25dihydroxyvitamin D. The enzyme that activates vitamin D is produced in the kidney, so blood levels of 1,25-dihydroxyvitamin D are sometimes of interest in patients on dialysis or with end-stage kidney disease. There are few other circumstances, if any, where 1,25-dihydroxyvitamin D testing would be helpful. Serum 25hydroxyvitamin D levels may be overused, but when trying to assess vitamin D stores or diagnose vitamin D deficiency (or toxicity), 25hydroxyvitamin D is the correct test. Methods We calculated the proportion of Medicare beneficiaries over age 65 that received at least one vitamin D screening test for each calendar year 2006-11. We then created a weighted average of testing prevalence for the interval 2006-11. We required enrollment in fee-for-service Medicare Parts A and B for at least 11 months in each calendar year. We excluded beneficiaries for whom a vitamin D screening test might be indicated, requiring at least two physician claims or one acute hospital claim for the relevant diagnoses. Exclusionary diagnoses included chronic kidney disease, osteoporosis, fragility fractures, and obesity. Fragility fractures were defined as follows: 175 (i) at least one CPT code for hip fracture repair; (ii) at least one diagnosis code for distal radius or proximal humerus fracture, plus at least one upper extremity radiography claim within seven days (plus or minus) of the diagnosis claim date; or (iii) at least one ICD-9 diagnosis code for vertebral fracture. CPT Codes for Identifying Vitamin D Screening Tests Labels Assay of Vitamin D; 25 hydroxy, includes fraction(s), if performed Assay of Calciferol (Vitamin D) Assay of Vitamin D Codes 82306 82307 82562 ICD-9 Codes for Excluding High-Risk Beneficiaries Labels Chronic kidney disease Hypertensive chronic kidney disease Hypertensive heart and chronic kidney disease Secondary diabetes mellitus with renal manifestations Diabetic nephropathy NOS Diabetic nephrosis Diabetes with renal manifestations Renal dialysis status Aftercare involving intermittent extracorporeal dialysis Aftercare involving intermittent other dialysis Osteoporosis Obesity Codes 585.x 403.x 404.x 249.4 583.81 581.81 250.4 V451, V4511, V4512 V560 V568 7330, 73300, 73301, 73302, 73303, 73309, V8281 278, 278.0x, V77.8 ICD-9 and CPT Codes for Identifying Fragility Fractures. Label Hip fracture Wrist fracture Humerus fracture Vertebral fracture Shoulder/clavicle imaging Humerus/elbow imaging Forearm/wrist imaging Hand imaging Code CPT 27230-27248 ICD-9 813.4-813.54, 814.00, 814.10 and CPT 25600, 25605, 25609, 25611 ICD-9 812.0-812.19 and CPT 2360023630, 23665-23680 ICD-9 805.2. 805.4, 805.8, 733.13 CPT 73000, 73010, 73020, 73030, 73040, 73050 CPT 73060, 73070, 73080, 73085 CPT 73090, 73092, 73100, 73110, 73115 CPT 73120, 73130, 73140 176 CT MRI CPT 73200, 73201, 73202, 73206 CPT 73218, 73219, 73220, 73221, 73222, 73223, 73225 177 Don’t use antipsychotics as first choice to treat behavioral and psychological symptoms of dementia Choosing Wisely Guidelines American Medical Directors Association American Geriatrics Society American Psychiatric Association Don’t prescribe antipsychotic medications for behavioral and psychological symptoms of dementia (BPSD) in individuals with dementia without an assessment for an underlying cause of the behavior. Careful differentiation of cause of the symptoms (physical or neurological versus psychiatric, psychological) may help better define appropriate treatment options. The therapeutic goal of the use of antipsychotic medications is to treat patients who present an imminent threat of harm to self or others, or are in extreme distress – not to treat nonspecific agitation or other forms of lesser distress. Treatment of BPSD in association with the likelihood of imminent harm to self or others includes assessing for and identifying and treating underlying causes (including pain; constipation; and environmental factors such as noise, being too cold or warm, etc.), ensuring safety, reducing distress and supporting the patient’s functioning. If treatment of other potential causes of the BPSD is unsuccessful, antipsychotic medications can be considered, taking into account their significant risks compared to potential benefits. When an antipsychotic is used for BPSD, it is advisable to obtain informed consent. Don’t use antipsychotics as first choice to treat behavioral and psychological symptoms of dementia. People with dementia often exhibit aggression, resistance to care and other challenging or disruptive behaviors. In such instances, antipsychotic medicines are often prescribed, but they provide limited benefit and can cause serious harm, including stroke and premature death. Use of these drugs should be limited to cases where non-pharmacologic measures have failed and patients pose an imminent threat to themselves or others. Identifying and addressing causes of behavior change can make drug treatment unnecessary. Don’t use antipsychotics as first choice to treat behavioral and psychological symptoms of dementia. Behavioral and psychological symptoms of dementia are defined as the non-cognitive symptoms and behaviors, including agitation or aggression, anxiety, irritability, depression, apathy and psychosis. Evidence shows that risks (e.g., cerebrovascular effects, mortality, parkinsonism or extrapyramidal signs, sedation, confusion and other cognitive disturbances, and increased body weight) tend to outweigh the potential benefits of antipsychotic medications in this population. Clinicians should limit the use of antipsychotic medications to cases where nonpharmacologic measures have failed and the patients’ symptoms may create a threat to themselves or others. This item is also included in the American Geriatric Society’s list of recommendations for “Choosing Wisely.” 178 Methods We calculated the percent of Medicare beneficiaries over age 65 with diagnosed dementia and without a severe mental illness who filled at least one antipsychotic in the interval 2006-11. We required enrollment in fee-for-service Medicare Parts A, B, and D, and weighted our analysis by beneficiary enrollment in Part D. Beneficiaries were classified as having a severe mental illness if they had at least one claim-level diagnosis for a severe mental illness during the study period. Beneficiaries were classified as having dementia if they had at least two physician or two acute hospital claims for dementia. Antipsychotic prescription fills were only counted if they occurred after the second (confirmed) dementia diagnosis. References Gruber-Baldini AL, Stuart B, Zuckerman IH, Simoni-Wastila L, Miller R. Treatment of dementia in community-dwelling and institutionalized medicare beneficiaries. Journal of the American Geriatrics Society. 2007;55(10):1508-16. doi:10.1111/j.1532-5415.2007.01387.x Rattinger GB, Burcu M, Dutcher SK, Chhabra PT, Rosenberg PB, Simoni-Wastila L, et al. Pharmacotherapeutic management of dementia across settings of care. Journal of the American Geriatrics Society. 2013;61(5):723-33. doi:10.1111/jgs.12210 ICD-9 Codes for Identifying Dementia Label Dementias Senile dementia, uncomplicated Presenile dementia Presenile dementia, uncomplicated Presenile dementia with delirium Presenile dementia with delusional features Presenile dementia with depressive features Senile dementia with delusion or depressive features Senile dementia with delusional features Senile dementia with depressive features Senile dementia with delirium Vascular dementia Vascular dementia, uncomplicated Vascular dementia with delirium Vascular dementia with delusions Vascular dementia with depressed mood Alcohol induced persisting dementia Dementia in conditions classified elsewhere Dementia in conditions classified elsewhere without behavioral disturbance Dementia in conditions classified elsewhere with behavioral disturbance Alzheimer’s disease Frontotemporal dementia Pick's disease of the brain Code 290.0 290.0 290.1 290.10 290.11 290.12 290.13 290.2 290.20 290.21 290.3 290.4 290.40 290.41 290.42 290.43 291.2 294.1 294.10 294.11 331.0 331.1 331.11 179 Frontal dementia Senile degeneration of the brain Cerebral degeneration in dx classified elsewhere Dementia with Lewy bodies / Parkinsonism 331.19 331.2 331.7 331.82 ICD-9 Codes for Identifying Severe Mental Illness Label Schizophrenic disorders Bipolar disorders Delusion disorders Other non-organic psychoses Code 295.0-295.9 296.0, 296.1, 296.4296.8 297.1-297.3, 297.8 298.3, 298.4 Drug Codes for Identifying Antipsychotic Prescriptions Label Perphenazine Fluphenazine Haloperidol Loxapine Mesoridazine Methotrimeprazine Molindone Pimozide Thioridazine Thiothixene Trifluoperazine Clozapine Risperidone Olanzapine Quetiapine Ziprasidone Aripiprazole Paliperidone Iloperidone Asenapine Lurasidone Code d00855 d00237 d00027 d00897 d00889 d00814 d00896 d00898 d00389 d00391 d00890 d00199 d03180 d04050 d04220 d04747 d04825 d06297 d07441 d07473 d07705 180 Don’t recommend percutaneous feeding tubes in patients with advanced dementia Choosing Wisely Guidelines American Academy of Hospice and Palliative Medicine American Geriatrics Society American Medical Directors Association Don’t recommend percutaneous feeding tubes in patients with advanced dementia; instead, offer oral assisted feeding. In advanced dementia, studies have found feeding tubes do not result in improved survival, prevention of aspiration pneumonia, or improved healing of pressure ulcers. Feeding tube use in such patients has actually been associated with pressure ulcer development, use of physical and pharmacological restraints, and patient distress about the tube itself. Assistance with oral feeding is an evidence-based approach to provide nutrition for patients with advanced dementia and feeding problems; in the final phase of this disease, assisted feeding may focus on comfort and human interaction more than nutritional goals. Don’t recommend percutaneous feeding tubes in patients with advanced dementia; instead offer oral assisted feeding. In advanced dementia, studies have found feeding tubes do not result in improved survival, prevention of aspiration pneumonia, or improved healing of pressure ulcers. Feeding tube use in such patients has actually been associated with pressure ulcer development, use of physical and pharmacological restraints, and patient distress about the tube itself. Assistance with oral feeding is an evidence-based approach to provide nutrition for patients with advanced dementia and feeding problems; in the final phase of this disease, assisted feeding may focus on comfort and human interaction more than nutritional goals. Don’t insert percutaneous feeding tubes in individuals with advanced dementia. Instead, offer oral assisted feedings. Strong evidence exists that artificial nutrition does not prolong life or improve quality of life in patients with advanced dementia. Substantial functional decline and recurrent or progressive medical illnesses may indicate that a patient who is not eating is unlikely to obtain any significant or long-term benefit from artificial nutrition. Feeding tubes are often placed after hospitalization, frequently with concerns for aspirations, and for those who are not eating. Contrary to what many people think, tube feeding does not ensure the patient’s comfort or reduce suffering; it may cause fluid overload, diarrhea, abdominal pain, local complications, less human interaction and may increase the risk of aspiration. Assistance with oral feeding is an evidence-based approach to provide nutrition for patients with advanced dementia and feeding problems. Methods We calculated the percent of Medicare beneficiaries over age 65 institutionalized with advanced dementia who received a feeding tube during 2006-11. Results were weighted by enrollment in fee-for-service Medicare Parts A and B and/or time alive. We only counted feeding tube placements that occurred in beneficiaries who had at least two physician and/or two acute 181 hospital dementia diagnoses and were also institutionalized for at least 90 days. (We began counting feeding tube placement after the date of institutionalization if it occurred before the second dementia diagnosis.) References Teno JM, Mitchell SL, Gozalo PL, Dosa D, Hsu A, Intrator O, et al. Hospital characteristics associated with feeding tube placement in nursing home residents with advanced cognitive impairment. JAMA : the journal of the American Medical Association. 2010;303(6):544-50. doi:10.1001/jama.2010.79 ICD-9 Codes for Identifying Patients with Advanced Dementia Label Dementias Senile dementia, uncomplicated Presenile dementia Presenile dementia, uncomplicated Presenile dementia with delirium Presenile dementia with delusional features Presenile dementia with depressive features Senile dementia with delusion or depressive features Senile dementia with delusional features Senile dementia with depressive features Senile dementia with delirium Vascular dementia Vascular dementia, uncomplicated Vascular dementia with delirium Vascular dementia with delusions Vascular dementia with depressed mood Alcohol induced persisting dementia Dementia in conditions classified elsewhere Dementia in conditions classified elsewhere without behavioral disturbance Dementia in conditions classified elsewhere with behavioral disturbance Alzheimer’s disease Frontotemporal dementia Pick's disease of the brain Frontal dementia Senile degeneration of the brain Cerebral degeneration in dx classified elsewhere Dementia with Lewy bodies / Parkinsonism Code 290 290.0 290.1 290.10 290.11 290.12 290.13 290.2 290.20 290.21 290.3 290.4 290.40 290.41 290.42 290.43 291.2 294.1 294.10 294.11 331.0 331.1 331.11 331.19 331.2 331.7 331.82 ICD-9 Codes for Identifying Feeding Tubes Label Percutaneous endoscopic gastrostomy tube Permanent or temporary gastrostomy tube Code 4311 4319 182 Endoscopic conversion of gastrostomy to J tube 4432 CPT Codes for Identifying Feeding Tubes Label Direct placement of PEG endoscopically Laparoscopic surgical gastrostomy Gastrostomy tube placement Open gastrostomy without Stamm procedure Open gastrostomy with Janeway procedure Insertion of PEG tube Conversion of percutaneous G to J Tube Radiologist assistance in PEG Insertion of gastrostomy tube, percutaneous Insertion of duodenostomy or jejunostomy tube, percutaneous Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous Replace G/C tube perc Replace Duod./Jej. tube perc Replace G-J tube perc Change gastrostomy tube Reposition gastrostomy tube Code 43246 43653 43750 43830 43832 44372 44373 74350 49440 49411 49446 49450 49451 49452 43760 43761 183 Don’t use opioid or butalbital treatment for migraine, except as a last resort Choosing Wisely Guideline American Academy of Neurology Don’t use opioid or butalbital treatment for migraine except as a last resort. Opioid and butalbital treatment for migraine should be avoided because more effective, migraine-specific treatments are available. Frequent use of opioid and butalbital treatment can worsen headaches. Opioids should be reserved for those with medical conditions precluding the use of migraine-specific treatments or for those who fail these treatments. Methods We calculated the percent of Medicare beneficiaries over age 65 with a migraine who had a filled prescription for an opioid or butalbital within 21 days of the migraine diagnosis in each calendar year 2006-11. We then created a weighted average for the interval 2006-11. Beneficiaries with migraines were identified using ICD-9 code 346.X. We excluded beneficiaries who were not enrolled in fee-for-service Medicare Parts A and B within 60 days of the migraine diagnosis, or Part D within one month of the index diagnosis. We also excluded beneficiaries with relevant diagnoses in the 60 days before the migraine diagnosis that could indicate appropriate use of an opioid or butalbital (e.g., surgery, back pain etc.), were admitted to a hospital, or had more than $200 of hospice spending. Drug Codes for Identifying Opioids and Butalbital Label Opioids Butalbital Code d03075, d00255, d00378, d00167, d00840, d00838, d00012, d00837, d00233, d03187, d00825, d00017, d00050, d00308, d05295, d00839, d00824, d00329, d00833, d00334, d00360, d04034, d07453 d03061 Codes for Excluding Beneficiaries Label External causes of injury Back pain Code Any “E” code ICD-9 721.3, 722.10, 722.32, 722.52, 722.90, 722.93, 184 Abdominal pain Fractures Surgery All cancers, except non-melanoma skin cancers 724.02, 724.2, 724.3, 724.5, 724.6, 724.7, 724.71, 724.79, 738.5, 739.3, 739.4, 846.0, 846.1, 846.2, 846.3, 846.8, 846.9, 847.2 CCS 251 CCS 207, 226, 228231 BETOS P codes CCS 11-22, 24-44 185